Cerebral Amyloid Angiopathy in a 78 year old female

Sagittal T1-weighted image (A) shows age appropriate parenchymal volume loss. Axial FLAIR image (B) demonstrates a small number of nonspecific hyperintense foci that are not unusual in a patient of this age. The axial diffusion weighted image (C) demonstrates no evidence of acute ischemia. Sequences A-C (group 1 sequences) show no definite abnormality that would explain the patient's symptoms. Axial gradient recalled echo image (D) reveals multiple punctate foci of susceptibility effect (white arrows) involving peripheral grey-white matter junctions, consistent with chronic microhemorrhages, which was not identified by the group 1 reader. This sequence alone (in addition to the other 3 sequences) provides the information needed to make the diagnosis of cerebral amyloid angiopathy