Rapid Progress of Unilateral Cerebral Microbleeds: A Novel ImagingFinding in Cerebral Amyloid Angiopathy-Related Inflammation

Lili Tang; Yujia Jin; Bingqian Wang; Yin Hu; Lusha Tong; Qiang Du

doi:10.71321/v8zybz49

Authors

Lili Tang Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
Yujia Jin The Second Affiliated Hospital of Zhejiang University, School of Medicine
Bingqian Wang Department of Encephalopathy, Yixing Traditional Chinese Medicine Hospital, Yixing, China
Yin Hu Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
Lusha Tong Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
Qiang Du Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China

DOI:

https://doi.org/10.71321/v8zybz49

Keywords:

Cerebral Amyloid Angiopathy-Related Inflammation, Unilateral Cerebral Microbleeds

Abstract

Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a rare but treatable CAA subtype characterized by reversible inflammatory mechanisms, offering unique diagnostic and therapeutic potential. We report a CAA-ri case featuring left-dominant cerebral microbleeds (CMBs) (baseline: 38 left vs. 2 right; 13-month progression to 65 left) with rapid clinical improvement post-corticosteroid therapy. This case expands the phenotypic spectrum of CAA-ri by demonstrating asymmetric CMBs with unilateral progression—a previously underrecognized pattern. This presentation requires heightened awareness in clinical practice to avert misdiagnosis and overlooked diagnoses.

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