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(Stroke. 2008;39:2894.)
© 2008 American Heart Association, Inc.

Research Letters

Superficial Siderosis

A Potential Diagnostic Marker of Cerebral Amyloid Angiopathy in Alzheimer Disease

Howard H. Feldman, MD; Luis F. Maia, MD; Ian R.A. Mackenzie, MD; Bruce B. Forster, MD; Jeff Martzke, PhD Andrew Woolfenden, MD

From Division of Neurology (H.H.F., J.M., A.W.), Department of Medicine, Division of Neuropathology (I.R.A.M.), Department of Pathology, Department of Radiology (B.B.F.), University of British Columbia, Vancouver, British Columbia, Canada; Department of Neurology (L.F.M.), Hospital Geral Santo António, Porto, Portugal.

Correspondence to Dr Howard H. Feldman, Division of Neurology, University of British Columbia Hospital, S192-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada. E-mail hfeldman{at}interchange.ubc.ca

Background and Purpose— Superficial siderosis of the central nervous system results from chronic bleeding in the superficial layers of the cortex and spinal cord. In cerebral amyloid angiopathy (CAA), there is amyloid deposition in meningeal and meningo-cortical arteries and capillaries, predisposing them to rupture. CAA is frequently associated with Alzheimer disease (AD).

Methods and Results— We report a series of 3 AD patients with MRI evidence of superficial siderosis. Two had neuropathological examination confirming superficial siderosis, AD, and CAA.

Conclusions— Superficial siderosis should be recognized within the spectrum of AD with CAA and considered as a possible antemortem diagnostic feature.

Key Words: Alzheimer disease • cerebral amyloid angiopathy • superficial siderosis

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Cerebral Amyloid Angiopathy, Hemorrhages and Superficial Siderosis

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