PMC6543005_01
Brain magnetic resonance imaging (MRI) of a patient with cerebral amyloid angiopathy (CAA)-related inflammation (CAA-RI) with the ApoE epsilon2/epsilon2 genotype. Before glucocorticoid treatment, axial fluid attenuated inversion-recovery (FLAIR) (A-D) sequences revealing multiple, asymmetrical subcortical white matter lesions, predominantly in the left lobe. The lesions are isointense on diffusion-weighted imaging (DWI) sequence (E), hyperintense on apparent diffusion coefficient (ADC) (F) and without parenchymal enhancement (G). MRA did not reveal abnormalities (H). Scattered hypointense lacunae (arrow head) and iso-hyperintense lesions (arrow) on the DWI sequence indicating microbleeds and subacute ischemia. On the follow-up MRI 2 months later, FLAIR lesions largely disappeared after glucocorticoid treatment (I-L). Susceptibility weighted imaging revealed no changes in diffuse microbleeds (M-P).
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F1
Subsequent susceptibility weighted imaging (SWI) confirmed diffuse microbleeds, mainly in the cortex (Figure 1). On follow-up brain MRI, diffuse white matter lesions largely improved with microbleeds unchanged (Figure 1), and prednisone was discontinued 1 month later.