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JAOA • Vol 109 • No 7 • July 2009 • 372-375
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CASE REPORT

Brain Amyloidoma With Cerebral Hemorrhage

 Henrick Labro, DO; Zaid Al-Kadhimi, MD; Mounir Djmil; Roger Oghlakian, MD; Amer Alshekhlee, MD, MS

From the Department of Medicine and Neurological Institute at St John West Shore Hospital, University Hospitals Case Medical Center in Cleveland, Ohio (Drs Labro, Oghlakian, and Alshekhlee and Mr Djmil), and from the Department of Oncology and Bone Marrow Transplant Center at Wayne State University in Detroit, Mich (Dr Al-Kadhimi).

Address correspondence to Henrick Labro, DO, Department of Medicine, St. Johns West Shore Hospital, University Hospitals Case Medical Center, 29000 Center Ridge Rd, Westlake, OH 44145. E-mail: henrick.labro{at}csauh.com

Unlike systemic amyloidosis, the diagnosis of brain amyloidoma without systemic manifestations is clinically challenging. Despite the availability of advanced brain imaging technology, such conditions are difficult to ascertain without brain biopsy or autopsy. We report the case of a 64-year-old woman who presented with frontal lobe syndrome with abnormal linear enhancement on brain magnetic resonance imaging. Results from a stereotactic biopsy revealed {lambda}-positive protein deposition in the brain parenchyma. During the course of illness, the patient had an acute cerebral hemorrhage, which manifested with hemiparesis, dysarthria, and pathologic crying. Review of the literature revealed 15 cases of primary brain amyloidoma. Patients had similar protein deposits but in different regions of the brain and therefore presented with various neurologic symptoms.






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