How to differentiate between cerebral amyloid angiopathy and Parkinson s disease?
Patient: I had Polio when I was a young child; I am now 78 years old and had a hemorrhagic stroke about 15 months ago. The Neurologist at the local hospital said they had no idea what caused the brain bleed ; so I consulted a Neurological Team (consisting of a Neurologist, a Vascular Specialist & a Neurological Surgeon) at Shands Hospital in Gainesville, Florida. This is the highly respected teaching hospital for the University of Florida. The neurologist diagnosed my problem as CAA. I have fallen 8 times and injured my head 3 times (one time resulting in 7 staples to close the wound in the back of my head & subdural hematoma (sp), and another time 5 stitches in my forehead). Each of the 8 times I fell I required assistance in getting to an upright position, something that was unknown to me before my stroke of 15 months ago. Before the stroke I was described by wife as disgustingly healthy , a term with which my personal physician also agreed. I would appreciate your answer to the similarities & differences between CAA, Post Polio Syndrome & Parkinson Disease. With Kind Regards Robert Moger Doctor: Hi,  The conditions you mention do not have much in common apart from being neurological conditions, there rarely is the needed to make a differential diagnosis between these conditions.   Post-polio syndrome is characterized mainly by fatigue and worsening of prior neurological sequelae of polio, it has none of the manifestations you mentioned.  Parkinson's disease is a chronic disease progressing over many years characterized mainly by slowing of the movement, rigidity and tremor. It may include falls but later on in the course of the disease, not in the first few years. There are no vascular lesions like hemorrhage on imaging.  CAA, on the other hand, is characterized by the presence of multiple hemorrhages on MRI imaging. Manifestations may vary depending on the manifestation of major bleeds and their location may manifest with motor deficits and seizures which might be causing your falls. So it is a diagnosis which is easily differentiated from the other two by imaging features, there shouldn't be an issue distinguishing these conditions from each other.  Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Olsi Taka,  Neurologist