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Cerebral amyloid angiopathy

Case contributed by Amro Omar
Diagnosis probable

Presentation

Demented patient, presented with acute neurological symptoms. Patient is normotensive.

Patient Data

Age: 80 years
Gender: Male
mri

T1 and T2WI show multiple peripheral foci of cerebral hemorrhage which are T1 bright and variably T2 isointense or bright, representing a mixture of acute/early subacute bleeds.

T2*WI shows numerous additional foci of punctate susceptibility artifact ("black dots"), consistent with angiopathic microbleeds.

Case Discussion

Top differential diagnoses for multifocal "black dots" on T2/T2* MR include various etiologies of small hemorrhages:

However, each of the above mentioned differential diagnoses has different clinical scenario and other supportive imaging features.

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