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Amyloid angiopathy is a potentially serious disorder of the arteries in the brain. Specific proteins called beta-amyloids infiltrate the blood vessels and stick to the walls, forming a plaque. The plaque limits blood flow and damages blood vessel tissue, which can potentially lead to a rupture and blood loss. Most people who have mild amyloid angiopathy do not experience symptoms or complications, though major bleeding may result in a life-threatening stroke. Doctors try to identify and treat symptoms as early as possible to avoid fatal outcomes in serious cases.
Researchers have yet to identify clear, direct causes of amyloid angiopathy. The main risk factor for the disorder is increasing age, as the majority of people who develop problems are over the age of 60. It is suspected that genetics may play a role as well 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, though it is not certain if amyloid proteins in the brain actually cause dementia symptoms.
The majority of patients who develop amyloid angiopathy are asymptomatic, especially in the early stages. Plaque buildups are small enough that they do not impair blood vessel functioning or cause ruptures. Serious artery damage often occurs gradually over time, which can lead to occasional and worsening symptoms of headache, vision changes, and mental confusion. If hemorrhaging is sudden and severe, a person may have an intense headache, blurred vision, slurred speech, drowsiness, and confusion. Seizures, comas, and sudden death are possible complications if emergency medical care is not available following a brain hemorrhage episode.
Amyloid angiopathy often goes undiagnosed until a person develops major symptoms. Magnetic resonance imaging scans are used to look for the presence of blood outside of brain arteries, but the test cannot explain what causes 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 bleeding is not discovered until an autopsy is performed.
When a patient starts experiencing symptoms, he or she is typically admitted to an intensive care unit for careful monitoring. Doctors first try to stabilize breathing and heart rate with oxygen therapy and reduce the chances of seizures with medications. Pressure around the brain due to blood and fluid buildup may need to be relieved with a surgical shunt. Once the patient is stable, tests can be run to look for underlying causes. There are currently no reliable treatments to prevent amyloid angiopathy symptoms from returning in the future.