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Reversible leukoencephalopathy associated with cerebral amyloid angiopathy

From the Neuroimmunology Branch (Dr. Oh), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Vascular Neurology (Dr. Gupta), The Cleveland Clinic Foundation, OH; and the Departments of Neurology (Drs. Krakauer and Elkind), Radiology (Dr. Khandji), and Pathology (Dr. Chin), and Sergievsky Center, College of Physicians and Surgeons (Dr. Elkind), Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. Mitchell S.V. Elkind, Neurological Institute, 710 West 168th Street, Room 641, New York, NY 10032; e-mail: mse13{at}columbia.edu

The authors describe three patients with reversible leukoencephalopathy associated with cerebral amyloid angiopathy (CAA). Rapid progression of neurologic symptoms was followed by dramatic clinical and radiographic improvement. Pathologically, CAA was associated with varying degrees of inflammation ranging from none to transmural granulomatous infiltration. In the appropriate clinical context, the MRI finding of lobar white matter edema with evidence of prior hemosiderin deposition may indicate the presence of a reversible CAA leukoencephalopathy.

Received May 28, 2003. Accepted in final form September 11, 2003.

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