What is the pathogenesis of cerebral amyloid angiopathy (CAA)?

Updated: Dec 19, 2018
  • Author: Ravi S Menon, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Answer

Amyloid deposition is complex and involves the following key processes:

  • Production of amyloid precursor proteins (APP)

  • Processing of precursor proteins

  • Aggregation of protein

  • Fibril formation

Impaired elimination and accumulation of soluble and insoluble β-amyloid peptide may underlie the pathogenesis of CAA and explain the link between CAA and Alzheimer disease (AD). Amyloid fibrils may deposit in cerebral vessels, as in β-amyloid CAA, or form senile plaques in brain parenchyma. [4]

The dynamic between accumulation and clearance of amyloid may be related to impaired drainage from perivascular basement membranes. Interstitial fluid and solutes drain from brain to cervical lymph nodes along basement membranes of capillaries and arteries powered by the pulsatile flow in these vessels (reverse transport). [5]


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