Abstract: Cerebral amyloid angiopathy （CAA） is an age-related cerebral small vessel disease characterized by β-amyloid deposition in the walls of small vessels in the cerebral cortex and the leptomeninges, leading to vascular dysfunction and perivascular brain injury. Its incidence increases significantly with age, and CAA is a major cause of lobar hemorrhage and dementia in the elderly. Currently, there are no disease-modifying treatments for CAA, and clinical management focuses primarily on reducing the occurrence and recurrence of intracerebral hemorrhage. However, the increasing prevalence of ischemic stroke with advancing age necessitates a comprehensive risk-benefit assessment of anticoagulant or antiplatelet therapies in CAA patients with concurrent ischemic stroke. Current research lacks adequate exploration of therapeutic strategies for this population. This review systematically addresses epidemiology, imaging biomarkers, hemorrhage risk stratification, antithrombotic approaches, and strategies to monitor bleeding risks.

Key words: cerebral amyloid angiopathy, ischemic stroke, cerebral microbleeds, cortical superficial siderosis, antithrombotic therapy