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Cerebral proliferative angiopathy

Egesta Lopci, Laura Olivari, Lorenzo Bello, Pierina Navarria, Arturo Chiti
We report the case of a 55-year-old woman with cerebral proliferative angiopathy (CPA). Her medical history included brain surgery for small vascular lesions and suspicion of cerebral malignancy. C methionine PET (C-METH PET) demonstrated a diffusely increased uptake on the right hemisphere. Contrast-enhanced MRI documented a massive lesion with a diffuse "nidus" appearance, involving the right cerebral hemisphere (sparing the inferior frontal gyrus and the anterior frontal lobe), the brainstem, and the middle cerebellar peduncle...
October 5, 2016: Clinical Nuclear Medicine
Hiroyuki Sakata, Miki Fujimura, Kenichi Sato, Kuniyasu Niizuma, Hidenori Endo, Teiji Tominaga
Cerebral proliferative angiopathy (CPA), which is characterized by diffuse vascular abnormalities with intermingled normal brain parenchyma, is a rare clinical entity distinct from classical cerebral arteriovenous malformations. Its pathology at initial state and subsequent course of progression has totally been undetermined. We herein presented a case of a child who was initially diagnosed with deep-seated arteriovenous fistula (AVF), and ultimately developed symptomatic CPA-like vascular lesion over a long period of clinical follow-up...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fatmir Bilaj, Arben Rroji, Eugen Enesi, Maren Ruka, Mentor Petrela
Cerebral proliferative angiopathy (CPA) is defined as a rare vascular disorder, characterized by diffuse arterial proliferation and distinctive angiogenetic features. Complication with hemorrhage is exceedingly rare, but once the bleeding occurs, the chance of re-bleeding is increased. Here we report a case of a patient with CPA complicated with bleeding and re-bleeding, and imaging findings mimicking a brain tumor, which has not been reported in the literature so far.
October 2016: Neuroradiology Journal
Peng Liu, Xianli Lv, Ming Lv, Youxiang Li
PURPOSE: Here we present our experience with five cerebral proliferative angiopathy (CPA) patients to better delineate the clinical and angiographic features as well as the treatment selection of this disease. METHODS: Between October 2008 and October 2012, five consecutive patients diagnosed with CPA were admitted to our department in our hospital. All the five patients received magnetic resonance imaging, digital subtraction angiography, and positron emission computed tomography (PET) to definitively confirm this disease...
February 2016: Interventional Neuroradiology
Sunil Kumar, Trilochan Srivastava, Shankar Tejwani, Kamlesh Khilnani
A young female presented with intermittent blurring of vision and mild to moderate headache for three months. Fundus examination revealed bilateral papilledema with secondary optic atrophy (right more than left). Computed tomography scan of brain showed a diffuse intraparenchymal vascular malformation in right parietooccipital region. Cerebral digital subtraction angiography (DSA) revealed diffuse nidus in right parietooccipital area, supplied by multiple branches of distal middle cerebral artery and anterior cerebral artery...
December 2015: Clinical Neurology and Neurosurgery
Geeta Anjum Khwaja, Vikram Bohra, Ashish Duggal, Abhilekh Srivastava, Neera Chaudhry
No abstract text is available yet for this article.
June 16, 2015: Neurology
Kenichi Kono, Tomoaki Terada
Cerebral proliferative angiopathy (CPA) is a rare clinical entity. This disorder is characterized by diffuse vascular abnormalities with intermingled normal brain parenchyma, and is differentiated from classic arteriovenous malformations. The management of CPA in patients presenting with nonhemorrhagic neurological deficits due to cerebral ischemia is challenging and controversial. The authors report a case of adult CPA with cerebral ischemia in which neurological deficits were improved after encephaloduroarteriosynangiosis (EDAS)...
December 2014: Journal of Neurosurgery
Eelco van Duinkerken, Menno M Schoonheim, Martijn D Steenwijk, Martin Klein, Richard G IJzerman, Annette C Moll, Martijn W Heymans, Frank J Snoek, Frederik Barkhof, Michaela Diamant
OBJECTIVE: Patients with longstanding type 1 diabetes may develop microangiopathy due to high cumulative glucose exposure. Also, chronic hyperglycemia is related to cerebral alterations and cognitive dysfunction. Whether the presence of microangiopathy is conditional to the development of hyperglycemia-related cerebral compromise is unclear. Since subcortical, rather than cortical, volume loss was previously related to cognitive dysfunction in other populations, we measured these brain correlates and cognitive functions in patients with longstanding type 1 diabetes with and without microangiopathy...
September 2014: Diabetes Care
Trilochan Srivastava, Tarun Mathur, Rahul Jain, Raghavendra Bakki Sannegowda
No abstract text is available yet for this article.
October 2013: Annals of Indian Academy of Neurology
Tomomi Kimiwada, Toshiaki Hayashi, Reizo Shirane, Teiji Tominaga
Cerebral proliferative angiopathy (CPA) is a new clinical entity demonstrating a diffuse network of densely enhanced vascular abnormalities with intermingled normal brain parenchyma and is distinguishable from classical arteriovenous malformations by specific clinical and imaging markers. However, the pathophysiological nature of this disease is unclear, and there is no consensus on the treatment. We describe cerebral perfusion abnormalities in a patient with CPA by using N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography (123I-IMP-SPECT) and perfusion-weighted magnetic resonance imaging...
November 2013: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
J J Gold, J R Crawford
A 9-year-old girl with a several-month history of unilateral intermittent headaches presented to the hospital with worsening headaches and unsteadiness. Neurologic exam was positive for a mild right hemiparesis and right homonymous hemianopsia. Noncontrast computed tomography revealed an engorged sagittal and straight sinus with prominent cortical veins concerning an arteriovenous malformation and the patient was admitted to the pediatric intensive care unit. Computed tomography angiogram demonstrated a left hemispheric vascular malformation, without evidence of dural arteriovenous fistula on conventional angiogram consistent with a diagnosis of cerebral proliferative angiopathy...
2013: Case Reports in Neurological Medicine
H Maekawa, M Tanaka, H Hadeishi
Cerebral proliferative angiopathy (CPA) is a rare vascular abnormality with several angiomorphological features that are distinct from brain arteriovenous malformations (AVMs). The natural history of CPAs indicates a lower risk for hemorrhage compared to brain AVMs. A 62-year-old woman presented with gait instability and dysarthria. MRI and angiography revealed a diffuse vascular network involving the tectum and cerebellar vermis with intermingled brain parenchyma. This lesion had no dominant feeder, high-flow arteriovenous shunt, flow-related aneurysm or highly dilated veins on angiogram...
September 2012: Interventional Neuroradiology
Michael P Marks, Gary K Steinberg
Cerebral proliferative angiopathy is a rare lesion marked by diffuse intravascular shunting, which should be differentiated from brain arteriovenous malformations. A patient is presented with cerebral proliferative angiopathy and documented progressive development of hypervascular shunting involving extensive portions of the left hemisphere. The patient had angiographic and laboratory evidence of angiogenesis and a progressive neurologic deterioration which corresponded to the development of her lesion. This is the first case which documents the progressive proliferative changes seen with this abnormality...
September 2012: Journal of Neurointerventional Surgery
Jorn Fierstra, Stephanie Spieth, Leanne Tran, John Conklin, Michael Tymianski, Karel G ter Brugge, Joseph A Fisher, David J Mikulis, Timo Krings
OBJECT: Cerebral proliferative angiopathy (CPA) has been morphologically distinguished from classically appearing brain arteriovenous malformations (AVMs) by exhibition of functional brain parenchyma that is intermingled with abnormal vascular channels. The presence of oligemia in this intralesional brain tissue may suggest ischemia, which is not detected in classic brain AVMs. The authors hypothesized that patients with CPA would exhibit a greater impairment of cerebrovascular reserve in neuronal tissue surrounding the true nidus compared with those with brain AVMs...
September 2011: Journal of Neurosurgery. Pediatrics
Guillaume Saliou, Timo Krings, Dik R Rutgers, Frederique Toulgoat, Augustin Ozanne, Pierre Lasjaunias, Denis Ducreux
INTRODUCTION: The aim of this study is to investigate perfusion characteristics of brain arteriovenous malformation (AVM) by means of MRI perfusion-weighted imaging (PWI). METHODS: Forty-three patients with brain AVM were prospectively included and investigated by PWI-MRI. Diagnosis of type of disease was made by angiogram. According to angiographic features, the study group was classified in three groups: two groups of patients with classical AVM (group 1 with few or no angiogenic feature (13 patients) and group 2 with many angiogenic features (18 patients)) and one group (group 3) which included patients with cerebral proliferative angiopathy (CPA; 12 patients)...
October 2011: Neuroradiology
Adviye Ergul
Diabetes is not only an endocrine but also a vascular disease. Cardiovascular complications are the leading cause of morbidity and mortality associated with diabetes. Diabetes affects both large and small vessels and hence diabetic complications are broadly classified as microvascular (retinopathy, nephropathy and neuropathy) and macrovascular (heart disease, stroke and peripheral arterial disease) complications. Endothelial dysfunction, defined as an imbalance of endothelium-derived vasoconstrictor and vasodilator substances, is a common denominator in the pathogenesis and progression of both macro and microvascular complications...
June 2011: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
MarĂ­a Catalina Vargas, Mauricio Castillo
Cerebral proliferative angiopathy (CPA) is an unusual type of vascular malformation with unique clinical and imaging characteristics that distinguish it from the classic arteriovenous malformations. The features of CPA include absence of dominant arterial feeders or flow-related aneurysms, capillary angioectasia without large draining veins, and presence of intermingled normal brain parenchyma that is hypoperfused. We describe the magnetic resonance imaging findings including perfusion in 3 patients with CPA...
January 2011: Journal of Computer Assisted Tomography
Michael J Ellis, Derek Armstrong, Peter B Dirks
The management of large and giant arteriovenous malformations (AVMs) in patients presenting with nonhemorrhagic neurological deficits secondary to vascular steal phenomenon is challenging and controversial. In many cases, large AVMs cannot be completely excised or cured, leaving patients with residual or partially treated AVMs, the natural history of which is unknown. Additionally, large, diffuse vascular malformations with multiple, small feeders, slow flow, or so-called cerebral proliferative angiopathy represent a related but distinct clinical and angiographic entity that may require a different therapeutic approach than traditional brain AVMs...
January 2011: Journal of Neurosurgery. Pediatrics
K S Hong, J I Lee, S C Hong
No abstract text is available yet for this article.
January 2010: Journal of Neurology, Neurosurgery, and Psychiatry
Eelco van Duinkerken, Martin Klein, Niki S M Schoonenboom, Roel P L M Hoogma, Annette C Moll, Frank J Snoek, Cornelis J Stam, Michaela Diamant
OBJECTIVE: Hyperglycemia-associated microvascular disease may underlie changes in cerebral functioning and cognitive performance in patients with type 1 diabetes. Functional connectivity, an indicator of functional interactions and information exchange between brain regions, provides a measure of cerebral functioning. This study addresses functional connectivity and cognition in type 1 diabetic patients with and without proliferative retinopathy, relative to healthy control subjects, using magnetoencephalography...
October 2009: Diabetes
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