A 74-year-old woman was admitted to our hospital with a history of episodes of left-sided
hemiparesis and numbness for few minutes. A brain MRI showed cortical subarachnoid
blood and diffuse cortical microbleeds, compatible with a diagnosis of cerebral amyloid
angiopathy, according to modified Boston criteria[1]. Other possible causes of the MRI findings, such as coagulopathy and traumatic brain
injury, were excluded.
Cerebral amyloid angiopathy, a common cause of lobar hemorrhage in older patients,
can also present with transient focal neurological episodes, which are sometimes known
as ‘amyloid spells’. These are stereotyped, recurrent, transient episodes of numbness
or weakness and may mimic a transient ischemic attack[1],[2],[3],[4],[5].
Figure T2*-weighted gradient-recalled echo MRI of a 74-year-old woman who presented with
transient neurological episodes. (A and B) Convexity subarachnoid hemorrhage and superficial
cortical siderosis involving the right central sulcus (arrow). (C and D) Cortical
microbleeds (arrowheads).'
