Summary

MRI-visible perivascular spaces are a recently recognised neuroimaging marker of cerebral small vessel diseases1 and centrum semiovale MRI-visible perivascular spaces may be a neuroimaging marker of cerebral amyloid angiopathy.2

We report an elderly woman with speech and memory disturbance, whose MR scan of brain showed severe centrum semiovale perivascular spaces. Subsequent MRI with blood-sensitive sequences showed multiple cerebral microbleeds, consistent with probable cerebral amyloid angiopathy. Dilated perivascular spaces can be a marker of cerebral amyloid angiopathy. Their recognition may change clinical management, since current recommendations for cerebral amyloid angiopathy treatment involve avoiding antithrombotic drugs and emphasising hypertensive control.