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Deliryum ile Ortaya Çıkan Serebral Amiloid Anjiopati İlişkili Subaraknoid Kanama

Serebral amiloid anjiopati (SAA) ilişkili intrakranial kanamalar lokalizasyon ve boyut olarak farklılık göstermektedir. Özellikle spontan lober hemorajiler görülmektedir. Leptomeningeal damarlarda yoğun amiloid tutulumuna rağmen SAA ilişkili subaraknoid kanama (SAK) nadirdir. 84 yaşında erkek hasta ani baş ağrısı, bilinç bozukluğu, halüsinasyon ve ajitasyon yakınması ile başvurdu. Bilgisayarlı tomografide beynin arka tarafında interhemisferik fissür çevresinde ve sol frontal lobda parankimal kanama alanları izlendi. İnterhemisferik fissürde de SAK düşündüren hiperdansite belirlendi. Manyetik rezonans görüntülemede periventriküler hiperintensite ve mikrohemoraji ile uyumlu hipointensite belirlendi. Bu klinik ve radyolojik durum SAA ilişkili hemoraji lehine değerlendirildi.

Delirium with Subarachnoid Hemorrhage Related-Cerebral Amyloid Angiopathy

Intracranial hemorrhages associated with cerebral amyloid angiopathy (CAA) may be different localization and size. Especially, spontaneous lobar hemorrhages are occur. CAA associated subarachnoid hemorrhage (SAH) is rare despite intense amyloid involvement in leptomeningeal vessels. 84-year-old male patient presented with acute headache, confusion, hallucination and agitation. Parenchymal hemorrhage was detected around interhemispheric fissure of posterior brain area and on the left frontal lobe at computed tomography. Also, hyperdensity was seen like SAH in interhemispheric fissure. Periventricular hyperintensity and hypointensity like microhemorrhagia was detected in magnetic resonance imaging. This clinical and radiological condition was evaluated as SAA-associated haemorrhage.

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