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Although amyloid-related imaging abnormalities (ARIA) occur predominantly early in treatment, reports of hemorrhagic events during extended treatment beyond 18 months remain limited. A 77-year-old woman completed a standard 1.5-year lecanemab regimen without ARIA on surveillance MRIs. The day after her 42nd infusion, she acutely developed confusion and incomprehensible speech. MRI revealed a 2.5-cm left parietal subcortical hemorrhage. This case highlights that symptomatic lobar hemorrhage may occur even during extended lecanemab therapy, underscoring the importance of continued safety monitoring during extended treatment.<\/jats:p>","DOI":"10.1177\/25424823261487915","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:39:40Z","timestamp":1788964780000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic lobar intracerebral hemorrhage during extended lecanemab treatment: A case report"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2252-431X","authenticated-orcid":false,"given":"Yugo","family":"Takahashi","sequence":"first","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Tsukahara","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nishina","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Uzu","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"},{"name":"Nippon Life Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuro","family":"Mori","sequence":"additional","affiliation":[{"name":"Nippon Life Hospital"},{"name":"Osaka University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212948"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad188"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.05.2351"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjpad.2026.100541"},{"key":"e_1_3_3_6_2","article-title":"Long-term safety and efficacy of lecanemab in early Alzheimer\u2019s disease: results from the clarity AD open-label extension study","volume":"21","author":"van Dyck CH","year":"2025","unstructured":"van Dyck CH, Sperling R, Johnson K, et al. 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