Abstract
Cerebral amyloid angiopathy is a well-recognised pathological process, more characteristically associated with advanced age. Iatrogenic cerebral amyloid angiopathy (iCAA) that develops secondary to the pathological seeding of amyloid deposits from affected donor tissue to recipient brain can lead to the development of amyloid angiopathy at a younger age. In Australia, the use of cadaveric dural tissue in neurosurgical procedures occurred from 1972 until its withdrawal in early 1987. Most cases of iCAA will present 3 to 5 decades post exposure. Thus, iCAA has emerging clinical relevance in Australia as the applicable population reaches this time period.
We present a case of multifocal intracerebral haemorrhage in the setting of probable iCAA. This 46 year old female had a history of childhood neurosurgical intervention at age 3 (1977). She presented to a tertiary hospital in Queensland, Australia with stereotyped episodes of hemisensory loss and headache leading up to an admission with multifocal intracerebral haemorrhages. Neuroimaging and post-mortem autopsy findings were consistent with presumed dural graft related iCAA.
Few cases of iCAA have been reported in Australia and it is still likely an under-recognised condition. We review the clinical presentation, radiological and histopathological findings with the aim to raise awareness of this rare disease.
