Transient focal neurological episodes - “amyloid spells”: a TIA mimic that should be recognized

Episódios neurológicos focais transitórios - “amyloid spells”: Um AIT mimic que deve ser reconhecido

A 74-year-old woman was admitted to our hospital with a history of episodes of left-sided hemiparesis and numbness for few minutes. A brain MRI showed cortical subarachnoid blood and diffuse cortical microbleeds, compatible with a diagnosis of cerebral amyloid angiopathy, according to modified Boston criteria¹. Other possible causes of the MRI findings, such as coagulopathy and traumatic brain injury, were excluded.

Cerebral amyloid angiopathy, a common cause of lobar hemorrhage in older patients, can also present with transient focal neurological episodes, which are sometimes known as ‘amyloid spells’. These are stereotyped, recurrent, transient episodes of numbness or weakness and may mimic a transient ischemic attack^1,2,3,4,5.

Figure.
T2*-weighted gradient-recalled echo MRI of a 74-year-old woman who presented with transient neurological episodes. (A and B) Convexity subarachnoid hemorrhage and superficial cortical siderosis involving the right central sulcus (arrow). (C and D) Cortical microbleeds (arrowheads).'

References

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Publication Dates

• Publication in this collection
  20 Jan 2020
• Date of issue
  Jan 2020

History

• Reviewed
  23 Feb 2019
• Received
  01 May 2019
• Accepted
  02 May 2019