J Stroke.  2024 Jan;26(1):1-12. 10.5853/jos.2023.01942.

Cerebral Amyloid Angiopathy: An Undeniable Small Vessel Disease

  • 1Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China


Cerebral amyloid angiopathy (CAA) has been proven to be the most common pathological change in cerebral small vessel disease except arteriosclerosis. In recent years, with the discovery of imaging technology and new imaging markers, the diagnostic rate of CAA has greatly improved. CAA plays an important role in non-hypertensive cerebral hemorrhage and cognitive decline. This review comprehensively describes the etiology, epidemiology, pathophysiological mechanisms, clinical features, imaging manifestations, imaging markers, diagnostic criteria, and treatment of CAA to facilitate its diagnosis and treatment and reduce mortality.


Amyloid angiopathy; Cerebral amyloid angiopathy-related inflammation; Amyloid β; Intracerebral hemorrhage


  • Figure 1. APOE gene and pathophysiological mechanism of cerebral amyloid angiopathy. APOE, apolipoprotein E; APP, amyloid precursor protein; Aβ, amyloid β; LDL, low-density lipoprotein.

  • Figure 2. Schematic diagram of the common imaging and typical magnetic resonance imaging findings of cerebral amyloid angiopathy. cSAH, convex subarachnoid hemorrhage; cSS, cortical superficial siderosis; EPVS, enlarged perivascular space; CMB, cerebral microbleed; WMH, white matter hyperintensity; CMI, cerebral microinfarction; ICH, intracerebral hemorrhage.



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