Pathology-Proven Cerebral Amyloid Angiopathy in a Patient With Spontaneous Intracerebral Hemorrhage

Cerebral amyloid angiopathy (CAA)–related intracerebral hemorrhage (ICH) accounts for 20% of spontaneous ICH. Results of brain magnetic resonance imaging (MRI) support the clinical diagnosis of suspected CAA and help predict future ICH. Here, we report an interesting case in which the MRI brain imaging demonstrated a left temporal ICH with no underlying mass and no evidence suggestive of amyloid angiopathy. Surgical evacuation of the hemorrhage was performed and histology was consistent with CAA. This case is noteworthy because the diagnosis of CAA was unsuspected owing to the absence of MRI brain findings as per Boston criteria 2.0.