Response to Letter Regarding Article, “Spectrum of Transient Focal Neurological Episodes in Cerebral Amyloid Angiopathy”

Response: We thank Dr Gomez-Choco and Dr Garcia for their interest in our multicenter study on transient focal neurological episodes (TFNE) in sporadic cerebral amyloid angiopathy (CAA)1 and for sharing their clinical experience on this interesting topic. Their remarks accord with our report and with converging evidence2,3 that TFNE may be related to hemorrhagic components of CAA including superficial cortical siderosis, probably reflecting previous acute bleeding into the subarachnoid space of adjacent cortical sulci (acute convexity subarachnoid hemorrhage [cSAH]). Their observations are also in keeping with our finding that TFNE may sometimes comprise negative rather than positive symptoms. We agree that it would be interesting to know how often acute (rather than chronic) bleeding into the subarachnoid space is a cause …