Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease in which β-amyloid peptides are deposited in leptomeningeal, cortical, and subcortical arteries, arterioles, and capillaries. Most individuals with CAA are asymptomatic. However, patients with CAA can present with cognitive impairment and other neurologic deficits caused by vascular wall amyloid deposition leading to hemorrhage. We present a unique case of CAA in a middle-aged woman with a history of cerebral cortex microhemorrhages and cortical edema. Imaging and pathology findings suggested CAA as the main etiology of this presentation. This is a very rare case of CAA coexisting with aneurysmal subarachnoid hemorrhage. Finally, we present a full discussion on the pathogenesis, clinical features, diagnosis, and treatment of CAA.
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