A 72-year-old man presented with headache, vomiting and diminution of vision. There was no history of smoking, diabetes mellitus, hypertension or use of aspirin or recreational drugs. The general physical examination, pulse, blood pressure, chest and cardiovascular examination were normal. On central nervous system examination, the visual acuity was reduced to perception of light at 6 m and pupils were 3 mm and reacting to light. Tests for cerebellar functions showed dysdiadochokinesia and impaired tandem walking. Blood investigations were normal and the axial MRI of the head disclosed a right occipital haematoma (figure 1) and other changes of probable cerebral amyloid angiopathy (figures 2 and 3). Figure 1 Axial MRI—gradient-echo technique showing multiple microbleeds (white arrowheads) in the cerebral hemispheres and a …