A 70-year-old woman reported recurrent episodes of right- or left-sided sensorimotor disturbance, thought to be recurrent transient ischaemic attacks. The episodes continued despite treatment with antiplatelet agents. When MRI revealed microhaemorrhages and focal superficial cortical haemosiderin deposition, antiplatelet agents were discontinued and her transient focal neurological episodes stopped. The imaging appearances suggested cerebral amyloid angiopathy (CAA) associated with superficial siderosis—although fulfilling criteria only for ‘possible CAA’. The case highlights the diversity of transient focal neurological episodes and the difficulties in current terminology and understanding of the clinical manifestations of CAA.