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Cerebral Amyloid Angiopathy — SCE Neurology MCQ

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HardCerebrovascular DiseaseCerebral Amyloid AngiopathySCE Neurology

A 56-year-old with progressive sensorineural deafness, cerebellar ataxia and pyramidal signs has diffuse infratentorial superficial siderosis on susceptibility MRI. Spine imaging also shows a chronic ventral extradural CSF collection after remote thoracic surgery. What management target offers the best chance of preventing further haemosiderin injury?

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Correct answer: E — Localise and repair the spinal dural defect causing chronic CSF leakage and bleeding

Explanation lettering: C = shown as B · B = shown as C · E = shown as D · D = shown as E

A treats the wrong haemorrhagic mechanism. B may worsen low pressure and does not stop bleeding. C does not address haemosiderin deposition. D is correct: infratentorial superficial siderosis can be a late complication of chronic spinal CSF leak, and management must focus on identifying and closing the dural source. E may address established deafness but cannot prevent neurological progression.

Reference: Spontaneous intracranial hypotension: https://pn.bmj.com/content/24/2/98