Amyloid angiopathy is a disease where beta-amyloid proteins form plaque in the arteries of the brain, potentially leading to a life-threatening stroke. Age is the main risk factor, and symptoms may include headaches, vision changes, and mental confusion. Diagnosis is difficult, and treatment focuses on stabilizing the patient and identifying underlying causes. There are currently no reliable treatments to prevent symptoms from returning.
Amyloid angiopathy is a potentially serious disease of the arteries of the brain. Specific proteins called beta-amyloid infiltrate blood vessels and stick to the walls, forming plaque. Plaque restricts blood flow and damages blood vessel tissue, which can potentially lead to a rupture and blood loss. Most people who have mild amyloid angiopathy experience no symptoms or complications, although major bleeding can lead to a life-threatening stroke. Doctors try to identify and treat symptoms as soon as possible to avoid fatal outcomes in severe cases.
Researchers have yet to identify clear and direct causes of amyloid angiopathy. The main risk factor for the disorder is increasing age, as most people who develop the disorder are over the age of 60. It is suspected that genetics may also play a role in cases involving family histories of angiopathy. Many studies have linked Alzheimer’s disease and other types of dementia to the presence of amyloid buildups, although it’s not certain whether amyloid proteins in the brain actually cause dementia symptoms.
Most patients who develop amyloid angiopathy are asymptomatic, especially in the early stages. Plaque buildups are small enough not to disrupt blood vessel function or cause ruptures. Severe damage to arteries often occurs gradually over time, which can lead to occasional and worsening symptoms of headaches, vision changes, and mental confusion. If the bleeding is sudden and severe, a person may have a severe headache, blurred vision, slurred speech, drowsiness, and confusion. Seizures, coma, and sudden death are possible complications if emergency medical care is not available following an episode of cerebral hemorrhage.
Amyloid angiopathy is often not diagnosed until a person develops core symptoms. MRI scans are used to look for blood outside the arteries of the brain, but the test cannot explain what is causing the blood loss. A brain biopsy is the only reliable way to confirm amyloid involvement. Biopsies are rarely performed, however, due to the inherent risks of surgery to remove brain tissue. Often, the true cause of the bleeding isn’t discovered until an autopsy is performed.
When a patient begins to experience symptoms, they are usually admitted to an intensive care unit for close monitoring. Doctors first try to stabilize breathing and heart rate with oxygen therapy and reduce the chances of seizures with medication. You may need to relieve pressure around the brain from blood and fluid buildup with a surgical shunt. Once the patient is stable, tests can be done to look for the underlying causes. There are currently no reliable treatments to prevent amyloid angiopathy symptoms from returning in the future.
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