[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-435997-105":59,"doc-detail-435997-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","cerebrospinal-fluid-biomarkers-in-cerebral-amyloid-angiopathy-insights-from-a-clinical-case-series","Cerebrospinal fluid biomarkers in cerebral amyloid angiopathy - insights from a clinical case series","","Cerebral amyloid angiopathy (CAA) is a small vessel disorder marked by amyloid-beta deposition in cerebral vessels, leading to intracerebral hemorrhage and cognitive impairment. Rare phenotypes, including CAA-related inflammation (CAA-ri) and iatrogenic CAA, can imitate other neurologic conditions and complicate diagnosis. Three clinical cases are presented with CSF biomarker analysis, showing decreased CSF Aβ40 and Aβ42 across all cases; one also had elevated p-tau. The report highlights CSF biomarkers as adjuncts to neuroimaging, supporting CAA and CAA-ri differentiation and emphasizing early recognition to enable potential immunotherapy, while noting the need for biomarker thresholds.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cerebrospinal-fluid-biomarkers-in-cerebral-amyloid-angiopathy-insights-from-a-clinical-case-series/435997/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cerebrospinal-fluid-biomarkers-in-cerebral-amyloid-angiopathy-insights-from-a-clinical-case-series/435997.png","ImageObject",300,407,{"name":92,"@type":93},"Eliana","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What role do CSF biomarkers play in diagnosing cerebral amyloid angiopathy (CAA) and CAA-ri?","Question",{"text":113,"@type":114},"CSF biomarkers, particularly low Aβ40 and Aβ42, complement neuroimaging by helping differentiate CAA and CAA-ri from other dementias.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What biomarker pattern was observed across the three clinical cases?",{"text":118,"@type":114},"All cases showed decreased levels of CSF Aβ40 and Aβ42, and one case demonstrated elevated p-tau suggesting coexisting Alzheimer’s pathology.",{"name":120,"@type":111,"acceptedAnswer":121},"Why is early recognition of CAA-ri variants important clinically?",{"text":122,"@type":114},"Early recognition and diagnosis can enable timely immunotherapy, which may improve outcomes.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},435997,1790793214,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},4398048949847,"https://ap-avatar.wpscdn.com/avatar/400002536579ef2da7f?_k=1778318612642679267","Article published online: 2025-11-28  \nPractice Neurology 1  \nCerebrospinal fluid biomarkers in cerebral amyloidangiopathy: insights from a clinical case series  \nAna Silvia Sobreira Lima Verde 1 Alessandra Braga Cruz Guedes de Morais 1,2  \nAmanda Vale Catunda 1 João Igor Dantas Landim 1 Ian Silva Ribeiro 1 Bruno Diógenes Iepsen 1 Norberto Anízio Ferreira Frota 1,3  \n1 Hospital Geral de Fortaleza, Departamento de Neurologia, Fortaleza CE, Brazil.  \n2 Universidade Federal de São Paulo, São Paulo SP, Brazil.  \n3 Universidade de Fortaleza, Fortaleza CE, Brazil Arq. Neuro-Psiquiatr. 2025;83(12):s00451812887 .  \nAddress for correspondence Ana Silvia Sobreira Lima Verde (email: [anasilvialimaverde@gmail.com](anasilvialimaverde@gmail.com))  \nAbstract  \nKeywords  \n► Cerebral Amyloid Angiopathy  \n► Biomarkers  \n► Amyloid BetaPeptides  \n► Cerebrospinal Fluid  \nCerebral amyloid angiopathy (CAA) is a small vessel disease characterized by the deposition of amyloid-beta in small cerebral vessels, which can lead to intracerebral hemorrhages and cognitive impairment. Rare variants, such as cerebral amyloidangiopathy-related inflammation (CAA-ri) and iatrogenic CAA (ICAA), may mimic other neurological conditions and challenge diagnosis in clinical practice. We present three cases that illustrate distinct CAA syndromes, along with CSF biomarker analysis. One patient experienced recurrent hemorrhagic strokes with a history of dural graft, raising concerns about amyloid transmission. Two patients presented with rapidly progressive dementia that fulfilled CAA-ri criteria. All cases exhibited decreased levels of CSF Aβ40 and Aβ42, with one showing elevated p-tau, suggesting comorbid Alzheimer ’s pathology. Cerebrospinal fluid biomarkers complement neuroimaging in the diagnosis of CAA, aiding in differentiation from other dementias. Early recognition and diagnosis of CAA-ri variants is crucial, because immunotherapy may improve outcomes. Further research is necessary to establish biomarker thresholds and their clinical applicability.  \nTEACHING POINTS  \n1. Cerebral amyloid angiopathy (CAA) can present with abroad clinical spectrum; therefore, recognition can be challenging, and the diagnostic criteria may lack accuracy, particularly in cerebral amyloid angiopathy-related inflammation (CAA-ri) variants.  \n2. Early recognition and diagnosis of CAA-ri variants allows for timely immunotherapy, potentially improving outcomes.  \n3. Cerebrospinal fluid (CSF) biomarkers (low Aβ40, Aβ42) may be useful adjuncts in diagnosing CAA and CAA-ri.  \nCLINICAL VIGNETTE  \nCase 1  \nA 45-year-old man presented with recurrent lobar hemorrhagic strokes beginning at 42 years old, affecting the bilateral occipitotemporal regions. He had a history of traumatic brain injury at 4 years old with dural graft placement. Brain magnetic resonance imaging (MRI) revealed multiple lobar microbleeds fulfilling Boston 2.0 criteria for probable CAA ( ►Figure 1). Cerebrospinal fluid biomarkers showed reduced Aβ40 and Aβ42 levels ( ►Table 1 ). Given the early onset, compatible imaging, biomarker profile, and prior neurosurgical exposure, the diagnosis of probable iatrogenic  \nreceived  \nFebruary 5, 2025  \nreceived in its final form August 5, 2025  \naccepted  \nSeptember 4, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1812887 . ISSN 0004-282X.  \nEditor-in-Chief: Hélio A. G. Teive.   \nAssociate Editor: Caio César Disserol Diniz.   \n© 2025 . The Author(s) .  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil  \n2 CSF biomarkers in CAA Verde et al.  \nFigure 1 Brain magnetic resonance imaging","cbCaio2dTJ85UxD4","https://ap.wps.com/l/cbCaio2dTJ85UxD4","pdf",2580535,"English","# Abstract\n# Teaching Points\n# Clinical Vignette\n## Case 1\n## Case 2\n## Case 3","[{\"question\":\"What role do CSF biomarkers play in diagnosing cerebral amyloid angiopathy (CAA) and CAA-ri?\",\"answer\":\"CSF biomarkers, particularly low Aβ40 and Aβ42, complement neuroimaging by helping differentiate CAA and CAA-ri from other dementias.\"},{\"question\":\"What biomarker pattern was observed across the three clinical cases?\",\"answer\":\"All cases showed decreased levels of CSF Aβ40 and Aβ42, and one case demonstrated elevated p-tau suggesting coexisting Alzheimer’s pathology.\"},{\"question\":\"Why is early recognition of CAA-ri variants important clinically?\",\"answer\":\"Early recognition and diagnosis can enable timely immunotherapy, which may improve outcomes.\"}]","Cerebrospinal fluid biomarkers in cerebral amyloid angiopathy - insights from a clinical case series | PDF",1790676349,15]