Table of Contents
Washington University Experience | VASCULAR | Congophilic Angiopathy (CAA) | 22A0 History
Case 22 History ---- This 73-year-old man developed a prior left parietal intracerebral hemorrhage, for which he underwent craniotomy and clot evacuation in Arizona in May 2018. He had been treated for atrial fibrillation for which he underwent cardioversion. He was chronically treated with anticoagulants, most recently Eliquis. On January 2019 his wife found him unresponsive with right sided flaccidity. CT of the head showed a large left frontal intraparenchymal hemorrhage (7 x 6 x 3.5 cm) with associated edema, mass effect, and cingulate and uncal herniation. His family transitioned him to comfort care shortly after admission. ---- Autopsy showed a 1590 g brain with an acute intraparenchymal hemorrhage in the left frontal-parietal lobe with extension into all ventricles and Duret hemorrhages. It was accompanied by an acute infarct of the right globus pallidus and basal ganglia and remote left parietal-occipital lobe encephalomalacia. The presence of diffuse severe congophilic angiopathy accompanied a modest degree of Alzheimer Disease Neuropathologic Changes.
