Cerebral amyloid angiopathy (CAA) related bleedings are an important cause of primary intracerebral hemorrhage (ICH). It is essential that radiologists are able to differentiate as many of the causes of ICH as possible. Our objective is to achieve a comprehensive overview of CAA related bleedings by addressing the following focus points: Illustrate the radiological and clinical features of cerebral amyloid angiopathy (CAA) related hemorrhages Demonstrate the usual appearance of CAA bleeds on CT Highlight the role of MRI in microbleed detection Emphasize the effectiveness of...

While cerebral amyloid angiopathy is a relatively common cause of non-traumatic intracerebral hemorrhage in the elderly (12-15% of hemorrhages above the age of 60) [1], it still remains under-diagnosed. It is probably because on the one hand CAA only makes up 2% of all ICH [2], and on the other CAA bleeds lack explicit clinical or imaging features. However, certain imaging clues together with the clinical data can be suggestive for CAA. In the following section we aim to lay out an overview on the...

In order to demonstrate the typical features of CAA related cerebral hemorrhage we have browsed through our department’s database for CAA related and other types of bleedings. Finally, 24 patients with intracranial hemorrhage were selected out of which 8 were suggestive of or proved to be CAA related bleedings. These CAA patients all showed intracerebral hemorrhage on CT and all were older than 65 years (average 75 years). Female to male ratio was 6:2.The hemorrhage was often extended, multilocular (involved 3 lobes on average) and...

CAA related bleedings represent only a small observable part of the disease. Ageing populations and the high prevalence of CAA in the elderly seem to result in the rise in the total number of cases. At the moment postmortem examination is still the gold standard for the diagnosis. We have shown that CT scans are appropriate to assess the more characteristic forms of CAA macrohemorrhages: multilocular, cortico-subcortically localized, cascade like bleeding. However, when only atypical unilocular bleeding is present CT scans alone are not suitable...

Acknowledgements We would like to thank for providing the complimentary MR images to our CT scans for Dr. György Várallyay (Fig. 1, 4, 9b, 10, 12); and Dr. Ildikó Kalina (Fig. 9d, 11a2, a3) from Semmelweis University MR Research Center, Budapest as well as Dr. Amy L. KotsenasDepartment of Radiology, Mayo Clinic, Rochester, Minnesota for helping out with Fig. 11b. Mehndiratta P, Manjila S, Ostergard T, Eisele S, Cohen ML, Sila C, Selman WR Cerebral amyloid angiopathyassociated intracerebral hemorrhage: pathology and management. Neurosurg Focus 32...