Fig. 7

CAA-related SS and MB in a 90-year-old man with pathologically proved AD. In addition to the right frontal subcortical MB (arrow), a 3D T2*-weighted image (a) demonstrated the typical gyriform low signals along the left cerebral sulci. Severe amyloid beta immunoreactive deposits were present in the leptomeningeal and cortical vessel walls of the parietal lobe (immunohistochemistry raised against monoclonal antibody Aβ 11–28) (b). The upper cortical layers were necrotic. Numerous haemosiderin-laden macrophages were present in the subarachnoid space and upper cortical layers (haematoxylin and eosin stain). These findings were consistent with superficial siderosis. A coronal FLAIR image (d) demonstrated left dominant atrophy of the amygdala and parahippocampal gyrus (arrowheads), and symmetric deep white matter hyperintensities (open arrowheads). A section of the left posterior hippocampus revealed atrophy of the hippocampus proper, subiculum and parahippocampal gyrus. Pallor of the subcortical white matter was evident (Klüver-Barrera stain) (e). There were numerous Aβ 11–28 immunoreactive senile plaques in the hippocampus (f)