Cerebral amyloid angiopathy with superficial siderosis

Case contributed by Andrew Lawson
Diagnosis certain



Patient Data

Age: 80 years
Gender: Female

A small focus of high density in the right frontal lobe appears to be cortical. No evidence of acute territorial infarction. Periventricular white matter hypoattenuation is in keeping with small vessel ischemia. Small old left frontal cortical infarction.

Multiple foci of susceptibility artefact are scattered throughout both cerebral hemispheres ranging in size from 2-12 mm. The largest region correlates to the high density demonstrated on the preceding CT scan. A superficial gyral pattern of signal drop off is most prominent in the right cerebral hemisphere. Diffuse periventricular deep white matter T2 hyperintensity changes are consistent with chronic small vessel ischemic disease. There are no regions of restricted diffusion.

Conclusion: Multiple foci of susceptibility artefact are findings consistent with amyloid angiopathy. The gyral signal drop off is consistent with secondary superficial siderosis.

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