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:

• multiple cavernomas, less likely due to lesion locations and patient's age
• hypertensive microangiopathy, less likely due to lesion locations and patient's normotensive state
• diffuse axonal injury, less likely due to no history of trauma

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