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Volume 17
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10.3390/neurolint17050064
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Background:
Case Report

Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT

by
Fumine Tanaka
1,*,
Maki Umino
1,
Megumi Matsukawa
1,
Seiya Kishi
2,
Ryota Kogue
1,
Norikazu Kawada
3,
Ken Kagawa
4,
Takaya Utsunomiya
5,
Hiroyuki Kajikawa
5,
Hidehiro Ishikawa
5,
Yuichiro Ii
6,
Akihiro Shindo
5,
Hajime Sakuma
1 and
Masayuki Maeda
7
1
Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, Japan
2
Department of Radiology, Matsusaka Chuo General Hospital, Matsusaka 515-0818, Mie, Japan
3
Department of Neurology, Matsusaka Chuo General Hospital, Matsusaka 515-0818, Mie, Japan
4
Department of Neurology, Suzuka Kaisei Hospital, Suzuka 513-0836, Mie, Japan
5
Department of Neurology, Mie University School of Medicine, Tsu 514-8507, Mie, Japan
6
Department of Neuroimaging and Pathophysiology, Mie University School of Medicine, Tsu 514-8507, Mie, Japan
7
Department of Neuroradiology, Mie University School of Medicine, Tsu 514-8507, Mie, Japan
*
Author to whom correspondence should be addressed.
Neurol. Int. 2025, 17(5), 64; https://doi.org/10.3390/neurolint17050064
Submission received: 20 March 2025 / Revised: 16 April 2025 / Accepted: 22 April 2025 / Published: 24 April 2025
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Abstract

Background/Objectives: A subtype of cerebral amyloid angiopathy (CAA), iatrogenic CAA (iCAA), has been increasingly reported. iCAA occurs primarily in patients who underwent surgery during childhood and is caused by the prion-like propagation of amyloid beta. This subtype of CAA tends to develop at a younger age than age-related CAA, usually before the age of 55. After a latency period of 20–40 years following surgery, it manifests as lobar intracerebral hemorrhage (ICH), cognitive impairment, or transient focal neurological episodes. Between 2023 and 2024, we observed four cases of possible iCAA, all of which had a history of neurosurgery during childhood. Case presentation: MRI findings for all cases revealed multiple lobar microbleeds. Two cases also showed cortical superficial siderosis and lobar ICH. Notably, contrast-enhanced 3D FLAIR demonstrated sulcal enhancement in two cases, and CT demonstrated cortical calcification in the bilateral posterior lobes in one case. Conclusions: Sulcal enhancement on contrast-enhanced 3D FLAIR and cortical calcification in the bilateral posterior lobes on CT may suggest advanced CAA in the present cases.
Keywords: iatrogenic cerebral amyloid angiopathy; magnetic resonance imaging; computed tomography iatrogenic cerebral amyloid angiopathy; magnetic resonance imaging; computed tomography

Share and Cite

MDPI and ACS Style

Tanaka, F.; Umino, M.; Matsukawa, M.; Kishi, S.; Kogue, R.; Kawada, N.; Kagawa, K.; Utsunomiya, T.; Kajikawa, H.; Ishikawa, H.; et al. Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT. Neurol. Int. 2025, 17, 64. https://doi.org/10.3390/neurolint17050064

AMA Style

Tanaka F, Umino M, Matsukawa M, Kishi S, Kogue R, Kawada N, Kagawa K, Utsunomiya T, Kajikawa H, Ishikawa H, et al. Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT. Neurology International. 2025; 17(5):64. https://doi.org/10.3390/neurolint17050064

Chicago/Turabian Style

Tanaka, Fumine, Maki Umino, Megumi Matsukawa, Seiya Kishi, Ryota Kogue, Norikazu Kawada, Ken Kagawa, Takaya Utsunomiya, Hiroyuki Kajikawa, Hidehiro Ishikawa, and et al. 2025. "Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT" Neurology International 17, no. 5: 64. https://doi.org/10.3390/neurolint17050064

APA Style

Tanaka, F., Umino, M., Matsukawa, M., Kishi, S., Kogue, R., Kawada, N., Kagawa, K., Utsunomiya, T., Kajikawa, H., Ishikawa, H., Ii, Y., Shindo, A., Sakuma, H., & Maeda, M. (2025). Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT. Neurology International, 17(5), 64. https://doi.org/10.3390/neurolint17050064

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