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Washington University Experience | VASCULAR | Amyloid-Beta Related Angiitis (ABRA) | 8A0 Case 8 History
Case 8 History ---- The patient is an 80 year old man who, in late September, began to complain of headaches, myalgias and abdominal pain, experienced increased daytime sleepiness, and fell several times without loss of consciousness. Evaluation at an outside hospital identified left-sided weakness. While in rehabilitation, he became combative and experienced hallucinations. Cerebrospinal fluid analysis identified pleocytosis concerning for CNS inflammation and he received corticosteroids; also noted were xanthochromia and elevated protein. CSF cultures for bacteria and fungi were negative, as were tests for multiple viruses and other pathogens. Several CSF cytology studies revealed bland T-lymphocytes, without evidence of a B-cell population. Brain MRI studies showed multiple small infarcts in the right frontoparietal cortex, the right occipital cortex and the posterior right centrum semiovale. Microhemorrhages were found in the right parietal cortex and white matter accompanied by leptomeningeal contrast enhancement. Operative procedure: Right sided open brain biopsy.
