Article Text

other Versions

PDF
Letter
In vivo amyloid imaging in cortical superficial siderosis
  1. Isabel Dhollander1,
  2. Natalie Nelissen2,
  3. Koen Van Laere3,
  4. Dirk Peeters4,
  5. Philippe Demaerel5,
  6. Wim Van Paesschen1,
  7. Vincent Thijs1,6,
  8. Rik Vandenberghe1,2
  1. 1Department of Neurology, University Hospitals Leuven, Belgium
  2. 2Laboratory for Cognitive Neurology, KU Leuven, Belgium
  3. 3Department of Nuclear Medicine, University Hospitals Leuven, Belgium
  4. 4Department of Neurology, AZ Groeninge, Kortrijk, Belgium
  5. 5Department of Radiology, University Hospitals Leuven, Belgium
  6. 6Vesalius Research Center, VIB, Leuven, Belgium
  1. Correspondence to Dr R Vandenberghe, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium; rik.vandenberghe{at}uz.kuleuven.ac.be

Statistics from Altmetric.com

Introduction

In superficial siderosis (SS), haemosiderin is deposited in the subpial layers of the central nervous system. SS can be diagnosed by the presence of a hypointense rim over the brain surface on gradient recalled echo (GRE) T2 weighted MRI, typically surrounding the brainstem and filling the cerebellar sulci. The classical triad consists of slowly progressive hearing loss, cerebellar ataxia and corticospinal tract signs. SS has classically been attributed to chronic or repeated subarachnoid haemorrhage, which may be otherwise clinically silent. In up to 65% of patients a bleeding source can be detected; the other cases have been labelled idiopathic.1 Recently, Feldman et al presented two patients with SS and histopathology of neuritic plaques and cerebral amyloid angiopathy (CAA).2 A few more patients have been published with both sporadic CAA and SS, without evidence of intraparenchymal amyloid.1 3 In a population based study Vernooij et al found SS in 0.7% of non-demented individuals, all of whom also had intracerebral microbleeds.4

11C-Pittsburgh compound B (PIB) positron emission tomography (PET) marks both vascular and parenchymal β amyloid plaques in vivo. We report 11C-PIB PET findings in two cases with SS. Our findings suggest that SS in the context of β amyloidosis may have a distinct clinical and MRI signature.

Case No 1

A 76-year-old woman with a history of hypercholesterolaemia who was taking acetylsalicylate presented with two episodes of hypoesthesia migrating from the right gluteal region to the right arm, associated with non-fluent speech, which lasted for a total of …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.