Multiple cerebral microbleeds and atypical β-amyloid deposits: A case report

RATIONALE: Cerebral microbleeds are increasingly recognized in various neurological disorders such as cerebral amyloid angiopathy (CAA), Alzheimer disease, and stroke. The presence and number of cerebral microbleeds are known to be independent predictors of cognitive impairment. PATIENT CONCERNS: A 73-year-old woman visited our memory disorder clinic complaining of progressive memory impairment, which started 2 years ago. DIAGNOSES: The patient had innumerable cortical/subcortical cerebral microbleeds in the entire brain. We diagnosed the patient with amnestic mild cognitive impairment due to CAA. Interestingly, only focal β-amyloid deposits at the bilateral parietal cortices were seen on amyloid positron emission tomography (PET) scan. INTERVENTIONS: We have observed changes in her cognitive function without any medication. OUTCOMES: The cognitive function of the patient was unchanged during the follow-up period. LESSONS: Our case was interesting in a few aspects, including the number of cerebral microbleeds and the atypical β-amyloid deposition pattern on amyloid PET scan. Further studies on more cases are needed to evaluate β-amyloid burden and distribution patterns in CAA.