Cerebral amyloid angiopathy

Case contributed by Dr Mohamed Samy

Presentation

Disturbed level of consciousness and focal neurological symptoms with history of declining cognitive performance. No history of elevated blood pressure.

Patient Data

Age: 70 years
Gender: Male
MRI
  • multiple punctate hypointense lesions are visible only on SWI in a cortico-medullary distribution, largely sparing the basal ganglia, eliciting blooming artifact, without mass effect or edema, likely representing multiple lobar cerebral microhemorrhages
  • leukoencephalopathy with a periventricular predilection and global cerebral atrophy are evident
  • Multiple infarcts of different chronological ages, including acute insults 

Case Discussion

Normotensive elderly patients with cortico-medullary distribution cerebral microbleeds is suggestive of a diagnosis of cerebral amyloid angiopathy.

The differential diagnosis for this case would include:

The established leukoencephalopathy, infarcts and brain atrophy all likely have a part in the patient's current presentation.

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Case information

rID: 62065
Published: 31st Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Private practice

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