Neuroimaging Demonstration of Evolving Small Vessel Ischemic Injury in Cerebral Amyloid Angiopathy

Background and Purpose-Cerebral amyloid angiopathy is a small to medium vasculopathy most commonly associated with symptomatic intracerebral hemorrhage and microbleeds. Summary of Case-We present a patient with cerebral microbleeds and likely amyloid angiopathy with evolving ischemic lesions visualized on diffusion-weighted imaging. Conclusions-This case captures with serial MRI the evolving and dynamic nature of cerebral amyloid angiopathy and particularly illustrates the subclinical, yet progressive, ischemic aspects of this vasculopathic process. (Stroke. 2009;40:e675-e677.)