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Cerebral amyloid angiopathy

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Right sided numbness. Crescendo TIA?

Patient Data

Age: 60 years
Gender: Male
ct

Established periventricular small vessel ischemic change.

No acute infarct or hemorrhage.

No intracranial calcification.

mri

Numerous foci of high T2 signal in the periventricular and deep white matter of both cerebral hemispheres in keeping with severe established ischemic change.  No acute focal or territorial infarct.

Innumerable small foci of susceptibility artifact at the grey-white matter interface of both cerebral hemispheres.  No involvement of the basal ganglia, dentate nuclei or pons.

Normal midline structures. Normal ventricular system.

 

Case Discussion

The widespread susceptibility artifact evident on the SWI with sparing of the basal ganglia and pons is typical of cerebral amyloid angiopathy.   

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