Cognitive decline and brain imaging suggesting cerebral microbleeds in a patient ≥50 years of age is consistent with cerebral amyloid angiopathy (CAA). CAA is an age-related small vessel disease marked by progressive amyloid-β deposition in cortical and leptomeningeal vessel walls. It is the leading cause of lobar intracerebral hemorrhage in older adults and can also contribute to age-related cognitive decline and dementia. Management primarily focuses on hemorrhage prevention with blood pressure control and careful consideration of the risks and benefits of antithrombotic therapy. Need a quick refresher? See the accompanying NEJM review article.
Comment
Cognitive decline and brain imaging suggesting cerebral microbleeds in a patient ≥50 years of age is consistent with cerebral amyloid angiopathy (CAA). CAA is an age-related small vessel disease marked by progressive amyloid-β deposition in cortical and leptomeningeal vessel walls. It is the leading cause of lobar intracerebral hemorrhage in older adults and can also contribute to age-related cognitive decline and dementia. Management primarily focuses on hemorrhage prevention with blood pressure control and careful consideration of the risks and benefits of antithrombotic therapy. Need a quick refresher? See the accompanying NEJM review article.