Cerebral Proliferative Angiopathy (CPA)

Cerebral proliferative angiopathy

Cerebral proliferative angiopathy (CPA), previously known as diffuse nidus type AVM, is a brain vascular malformation separated from classic brain AVM. CPA is a separate clinical entity different from cerebral AVMs, because normal brain is interspersed with the abnormal vascular channels.

CPA is present in 3.4% of all brain AVMs. It is more common in women than men with a F:M ratio of 2:1.

Medical attention should be sought if any signs or symptoms such as seizures, headaches or other neurological symptoms are noticed.

Cerebral angiography is the gold standard for diagnosis. In contrast to classical AVM, there are usually absence of early venous drainage, absence of a dominant feeder, a fuzzy appearance of nidus, distinguishing CPA.

The treatment for cerebral proliferative angiopathy carries the risk of neurological damage attributable to the interspersed normal neural tissue and thus it is usually limited to those patients presenting with severe symptoms. Surgical resection is less of an option. Surgery is usually reserved for CPA-complications such as bleeding. Radiosurgery is the treatment of choice for CPA.