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Cerebral amyloid angiopathy

Findings:
A hemosiderin lined cavity is present in the left occipital lobe with blooming on gradient echo imaging.
Additionally, subarachnoid siderosis is noted in the left parietal and occipital lobes.
On the SWI images 3-4 cortical/lobar microbleeds are noted in both cerebral hemispheres. No deep white matter or pontine microbleeds.
Patchy zones of T2/Flair hyperintensity involving the subcortical and periventricular cerebral white matter are noted, in keeping with moderate small vessel ischemic disease. No diffusion restriction.
The ventricles and sulcal spaces are within normal limits. The midline structures are normal with no midline shift.
The pituitary gland is normal.
The orbits, paranasal sinuses and mastoid air cells are clear. Bilateral IOL-implants are seen.
No bony abnormality is seen. ACDF is noted in the imaged of her cervical spine.

Conclusion:
Posthaemorrhagic area of encephalomalacia in the left occipital lobe.
A few lobar microbleeds as well as left parieto-occipital subarachnoid siderosis, most likely in keeping with cerebral amyloid angiopathy.

Updated on 29. March 2023

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About the author

Dr Sara Mohebbi is a Consultant Radiologist (Facharzt für Radiologie) with sub-specialty training in neuroradiology. She served as Chief Resident at University Hospital Freiburg and is a member of the European Society of Radiology (ESR). Her clinical focus includes demyelinating disease, neuro-oncology, and vascular neuroimaging. Dr Mohebbi is the Clinical Lead at Radiology Prime, where she provides independent second opinion reports on brain and spine MRI.