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CAA-related lobar haemorrhage — SCE Neurology MCQ

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HardStrokeCAA-related lobar haemorrhageSCE Neurology

A 68-year-old has a lobar occipital haemorrhage, recurrent transient focal neurological episodes, cortical microbleeds and disseminated superficial siderosis, without another cause. Which diagnosis best fits?

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Correct answer: E — Probable cerebral amyloid angiopathy, in this clinical phenotype

The best answer is “Probable cerebral amyloid angiopathy, in this clinical phenotype”. Strictly lobar haemorrhagic lesions and cortical superficial siderosis in an older adult satisfy the imaging pattern for probable CAA. “Hypertensive deep perforator arteriopathy” can be reasonable in another presentation, but it does not account for the defining feature here. “Aneurysmal subarachnoid haemorrhage” can be reasonable in another presentation, but it does not account for the defining feature here. “Cerebral venous sinus thrombosis” can be reasonable in another presentation, but it does not account for the defining feature here. “Multiple cavernous malformations” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: Boston criteria version 2.0 for cerebral amyloid angiopathy: https://pubmed.ncbi.nlm.nih.gov/35841910/