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This research aims to highlight cerebral amyloid angiopathy-related inflammation as a reversible cause of rapidly progressive dementia.

April 22, 2026Discover Medicine0 citationsOpen Access

Cerebral amyloid angiopathy-related inflammation presenting with relapsing rapidly progressive dementia

VLVikas LakhanpalCentral University of Punjab HSHarkaran Singh SahniCentral University of Punjab SGSarvpreet Singh GrewalCentral University of Punjab

Key Points

This research aims to highlight cerebral amyloid angiopathy-related inflammation as a reversible cause of rapidly progressive dementia.
Detailed clinical assessment of a 68-year-old male patient.
MRI imaging to identify characteristic features of CAA-ri.
Treatment with intravenous methyl-prednisolone.
Patient exhibited cognitive and behavioral improvement post-treatment.
MRI showed features consistent with probable CAA-ri including periventricular hyperintensities and microbleeds.
Minor memory deficits remained despite overall cognitive enhancement.

Abstract

Cerebral amyloid angiopathy-related inflammation (CAA-ri) is an uncommon but treatable cause of rapidly progressive dementia (RPD). Unlike prion or degenerative dementias, it can show partial reversibility with immunotherapy. A 68-year-old man developed 3 months of fluctuating cognitive decline with disorientation, behavioural disturbances and memory disturbances. MRI revealed periventricular white matter hyperintensities and multiple cortical microbleeds, consistent with probable CAA-ri. He improved after intravenous methyl-prednisolone, with improvement in memory and behavioural domains, though minor memory deficits persisted. CAA-ri should be considered in elderly patients with relapsing RPD. Recognition of its characteristic MRI features enables timely immunotherapy, which may stabilize or partially reverse cognitive decline.

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