Cerebral amyloid angiopathy

Presentation

Stroke.

Patient Data

Age: 70 years old
Gender: Male
Modality: MRI

An intra-axial right occipitoparietal haemorrhage exhibiting hyperintense signal on T1W, T2WI and in FLAIR. No perilesional oedema and no significant mass effect.

Innumerable foci of blooming artefact in keeping with blood products are present in the supra and infratentorial brain.

Multiple periventricular and right basal ganglia small focal abnormal signal intensities that are isointense at T1WI, but hyperintense at T2WI and FLAIR with no diffusion restriction, suggestive of chronic small vessel ischaemiat

 No mass effect or perilesional oedema .

Case Discussion

The peripheral distribution of these microhaemorrhages is very characteristic of cerebral amyloid angiopathy with little if any viable alternative diagnosis. 

Multiple cavernomas invariably have some blooming artifacts that are larger and visible on other sequences. They do not spare the basal ganglia. 

Miliary haemorrhagic metastases would be expected to also be more random and to have some enhancement and oedema.

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Case Information

rID: 52298
Case created: 1st Apr 2017
Last edited: 5th Apr 2017
Inclusion in quiz mode: Included

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