A Case of Multiple Intracerebral Hemorrhages Due to Early-Onset Cerebral Amyloid Angiopathy With Alzheimer's Disease: Neuropathological Changes Three Decades After Childhood Neurosurgery.

Cerebral amyloid angiopathy (CAA) is a disease in which amyloid beta (Aβ) is deposited in blood vessels and meninges in the brain. Cerebral amyloid angiopathy typically occurs in the elderly but is also known to occur in younger patients with a history of childhood head trauma or dura graft following neurosurgical procedures. The patient was a 39-year-old female who had undergone neurosurgery for an arachnoid cyst in the right temporal lobe at the age of two years. Severe headache, dizziness, and right leg weakness developed abruptly. The Aβ42/40 ratio had decreased in cerebrospinal fluid. Brain MRI showed multiple cerebral hemorrhages. Considering CAA, a brain biopsy was performed. Pathological examination showed severe CAA in many leptomeningeal and cortical vessels. We reported early-onset CAA after neurosurgery in childhood. In young patients with cerebral hemorrhages, it is necessary to consider early-onset CAA following childhood head trauma or neurosurgery.