Cerebral amyloid angiopathy

Case contributed by Khalid Alhusseiny
Diagnosis almost certain

Presentation

Disturbed level of consciousness and generalized body weakness.

Patient Data

Age: 85 years
Gender: Male
mri

Bilateral cerebral, and to lesser extent cerebellar, multiple microhemorrhages are seen at the grey-white matter junction showing low signal blooming artifact on SWI with similar signal abnormality outlining the sulci at the left fronto-parietal region denoting cortical superficial siderosis.

Atrophic brain changes with moderate dilatation of the ventricular system, deepened sulci and chronic ischemic changes.

Left maxillary, ethmoidal, frontal and sphenoidal sinusitis with left maxillary retention cyst.

Case Discussion

Cerebral amyloid angiopathy can present on MRI with different types of hemorrhage, including parenchymal 'lobar' hemorrhage, microhemorrhage, convexal subarachnoid hemorrhage or cortical superficial siderosis. These different patterns of hemorrhage are easily detectable on GRE or SWI sequences.

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