Skip to main content
Log in

Cerebral amyloid angiopathy in the aged

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Cerebral amyloid angiopathy (CAA) was found in 57% of 123 autopsy brains removed from patients aged 59–101 years. The incidence of CAA increased with age. CAA was seen most frequently in the occipital cortex. Immunohistochemically, amyloid of CAA was positive for amyloid P component and negative for human AA protein and human prealbumin. The presence and severity of CAA were significantly correlated with the number of senile plaques and neurofibrillary tangles. The incidence of CAA in 17 patients with dementia of Alzheimer type (DAT) was estimated to be 88% and was significantly higher than that in 26 patients with dementia of non-Alzheimer type. CAA had a pathogenetic relationship with both brain ageing and DAT. Lobar cerebral haemorrhage was found in 3 patients with CAA of marked or moderate degree. Lobar cerebral haemorrhage in the aged and in patients with DAT suggest the presence of CAA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cosgrove GR, Leblanc R, Meagher-Villemure K, Ethier R (1985) Cerebral amyloid angiopathy. Neurology 35:625–631

    Article  CAS  PubMed  Google Scholar 

  2. Finelli PF, Kessimian N, Bernstein PW (1984) Cerebral amyloid angiopathy as recurrent intracerebral hemorrhage. Arch Neurol 41:330–333

    Article  CAS  PubMed  Google Scholar 

  3. Fujihara S, Barlow JE, Costa JC, Costa JC, Glenner GG (1980) Identification and classification of amyloid in formalin-fixed, paraffin-embedded tissue sections by the unlabeled immunoperoxidase method. Lab Invest 43:358–365

    CAS  PubMed  Google Scholar 

  4. Gilbert JJ, Vinters HV (1983) Cerebral amyloid angiopathy: incidence and complications in the aging brain. I. Cerebral hemorrhage. Stroke 14:915–923

    Article  CAS  PubMed  Google Scholar 

  5. Glenner GG (1979) Congophilic microangiopathy in the pathogenesis of Alzheimer's syndrome (presenile dementia). Med Hypotheses 5:1231–1236

    Article  CAS  PubMed  Google Scholar 

  6. Glenner GG, Wong CW (1984) Alzheimer's disease: initial report of the purification and characterization of a novel cerebrovascular amyloid protein. Biochem Biophys Res Commun 120:885–890

    Article  CAS  PubMed  Google Scholar 

  7. Gray F, Dubas F, Roullet E, Escourolle R (1985) Leukoencephalopathy in diffuse hemorrhagic cerebral amyloid angiopathy. Ann Neurol 18:54–59

    Article  CAS  PubMed  Google Scholar 

  8. Gudmundsson G, Hallgrímsson J, Jónasson TÁ, Bjarnason 'O (1972) Hereditary cerebral haemorrhage with amyloidosis. Brain 95:387–404

    Article  CAS  PubMed  Google Scholar 

  9. Ishii T, Haga S, Shimizu F (1975) Identification of components of immunoglobulins in senile plaques by means of fluorescent antibody technique. Acta Neuropathol (Berl) 32:157–162

    Article  CAS  PubMed  Google Scholar 

  10. Ishii T, Hosoda Y, Ikegami N, Shimada H (1983) Senile amyloid deposition. J Pathol 139:1–22

    Article  CAS  PubMed  Google Scholar 

  11. Ishii N, Nishihara Y, Horie A (1984) Amyloid angiopathy and lobar cerebral haemorrhage. J Neurol Neurosurg Psychiatry 47:1203–1210

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Jellinger K (1977) Cerebrovascular amyloidosis with cerebral hemorrhage. J Neurol 214:195–206

    Article  CAS  PubMed  Google Scholar 

  13. Kalyan-Raman UP, Kalyan-Raman K (1984) Cerebral amyloid angiopathy causing intracranial hemorrhage. Ann Neurol 16:321–329

    Article  CAS  PubMed  Google Scholar 

  14. Kidd M, Allsop D, Landon M (1985) Senile plaque amyloid, paired helical filaments, and cerbrovascular amyloid in Alzheimer's disease are all deposits of the same protein. Lancet I:278–279

    Article  Google Scholar 

  15. Mandybur TI (1975) The incidence of cerebral amyloid angiopathy in Alzheimer's disease. Neurology 25:120–126

    Article  CAS  PubMed  Google Scholar 

  16. Mandybur TI (1979) Cerebral amyloid angiopathy: possible relationship to rheumatoid vasculitis. Neurology 29:1336–1340

    Article  CAS  PubMed  Google Scholar 

  17. Mandybur TI (1986) Cerebral amyloid angiopathy: the vascular pathology and complications. J Neuropathol Exp Neurol 45:79–90

    Article  CAS  PubMed  Google Scholar 

  18. Mandybur TI, Stephen RD, Bates MB (1978) Fatal massive intracerebral hemorrhage complicating cerebral amyloid angiopathy. Arch Neurol 35:246–248

    Article  CAS  PubMed  Google Scholar 

  19. Masuda J (1985) Incidence of cerebral amyloid angiopathy in autopsy cases in Hisayama, Japan. Jpn J Geriatr 22:138–143

    CAS  Google Scholar 

  20. Morimatsu M, Hirai S, Muramatsu A, Yoshikawa M (1975) Senile degenerative brain lesions and dementia. J Am Geriatr Soc 23:390–406

    Article  CAS  PubMed  Google Scholar 

  21. Mountjoy CQ, Tomlinson BE, Gibson PH (1982) Amyloid and senile plaques and cerebral blood vessels. A semi-quantitative investigation of a possible relationship. J Neurol Sci 57:89–103

    Article  CAS  PubMed  Google Scholar 

  22. Nakazato M, Kangawa K, Minamino N, Tawara S, Matuso H, Araki S (1984) Identification of a prealbumin variant in the serum of a Japanese patient with familial amyloidotic polyneuropathy. Biochem Biophys Res Commun 122:712–718

    Article  CAS  PubMed  Google Scholar 

  23. Okazaki H, Reagan TJ, Campbell RJ (1979) Clinicopathologic studies of primary cerebral amyloid angiopathy. Mayo Clin Proc 54:22–31

    CAS  PubMed  Google Scholar 

  24. Pantelakis S (1954) Un type particulier d'angipathie sénile du système nerveux central: l'angiopathie congophile. Topographie et fréquence. Monatsschr Psychiatr Neurol 128:219–256

    Article  CAS  PubMed  Google Scholar 

  25. Pitkänen P, Westermark P, Cornwell III GG (1984) Senile systemic amyloidosis. Am J Pathol 117:391–399

    PubMed  PubMed Central  Google Scholar 

  26. Powers JM, Schlaepfer WW, Willingham MC, Hall BJ (1981) An immunoperoxidase study of senile cerebral amyloidosis with pathogenetic considerations. J Neuropathol Exp Neurol 40:592–612

    Article  CAS  PubMed  Google Scholar 

  27. Scholz W (1938) Studien zur Pathologie der Hirngefäße II. Die drüsige Entartung der Hirnarterien und -capillaren. Z Gesamte Neurol Psychiatr 162:694–715

    Article  Google Scholar 

  28. Shirahama T, Skinner M, Cohen AS (1981) Immunocytochemical identification of amyloid in formalin-fixed paraffin sections. Histochemistry 72:161–171

    Article  CAS  PubMed  Google Scholar 

  29. Shirahama T, Skinner M, Westermark P, Rubinow A, Cohen AS, Brun A, Kemper TL (1982) Senile cerebral amyloid. Prealbumin as a common constituent in the neuritic plaque, in the neurofibrillary tangle, and in the microangiopathic lesion. Am J Pathol 107:41–50

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Sletten K, Westermark P, Natvig JB (1980) Cardiac amyloid is related to prealbumin. Scand J Immunol 12:503–506

    Article  CAS  PubMed  Google Scholar 

  31. Störkel S, Bohl J, Schneider HM (1983) Senile amyloidosis: principles of localization in a heterogeneous form of amyloidosis. Virchows Arch [A] 44:145–161

    Article  Google Scholar 

  32. Tawara S, Nakazato M, Kangawa K, Matsuo H, Araki S (1983) Identification of amyloid prealbumin variant in familial amyloidotic polyneuropathy (Japanese type). Biochem Biophys Res Commun 116:880–888

    Article  CAS  PubMed  Google Scholar 

  33. Tomonaga M (1981) Cerebral amyloid angiopathy in the elderly. J Am Geriatr Soc 29:151–157

    Article  CAS  PubMed  Google Scholar 

  34. Torack RM (1975) Congophilic angiopathy complicated by surgery and massive hemorrhage. A light and electron microscopic study. Am J Pathol 81:349–366

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Vinters HV, Gilbert JJ (1983) Cerebral amyloid angiopathy: incidence and complications in the aging brain. II. The distribution of amyloid vascular changes. Stroke 14:924–928

    Article  CAS  PubMed  Google Scholar 

  36. Westermark P, Shirahama T, Skinner M, Norén P, Cohen AS (1981) Amyloid P-component (protein AP) in localized amyloidosis as revealed by an immunocytochemical method. Histochemistry 71:171–175

    Article  CAS  PubMed  Google Scholar 

  37. Westermark P, Shirahama T, Skinner M, Brun A, Cameron R, Cohen AS (1982) Immunohistochemical evidence for the lack of amyloid P component in some intracerebral amyloids. Lab Invest 46:457–460

    CAS  PubMed  Google Scholar 

  38. Wright JR, Calkins E, Breen WJ, Stolte G, Schultz RT (1969) Relationship of amyloid to aging. Review of the literature and systematic study of 83 patients derived from a general hospital population. Medicine 48:39–60

    Article  CAS  PubMed  Google Scholar 

  39. Wright JR, Calkins E, Humphrey RL (1977) Potassium permanganate reaction in amyloidosis. A histologic method to assist in differentiating forms of this disease. Lab Invest 36:274–281

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamada, M., Tsukagoshi, H., Otomo, E. et al. Cerebral amyloid angiopathy in the aged. J Neurol 234, 371–376 (1987). https://doi.org/10.1007/BF00314080

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00314080

Key words

Navigation