Published Online
on July 17, 2008

A more recent version of this article appeared on October 1, 2008

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Submitted on December 27, 2007
Accepted on January 17, 2008

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; and 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.

^* To whom correspondence should be addressed. 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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