CT Diagnosis of Cerebral Amyloid Angiopathy

Greenberg, Steven M.

doi:10.1212/wnl.0000000000200506

Cited by 4 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 Image Analysis/Processing Hemorrhagic markers were assessed on T 2 *-weighted images. Lobar microbleeds (location as described by the Boston criteria 28 ) were defined and scored, as described previously. 29 ICHs were defined as parenchymal defects with evidence of hemosiderin in their wall.…”

Section: Image Acquisitionmentioning

confidence: 99%

Longitudinal Progression of Magnetic Resonance Imaging Markers and Cognition in Dutch-Type Hereditary Cerebral Amyloid Angiopathy

Dijk

Lak

Berg-Huysmans

et al. 2022

Stroke

Self Cite

View full text Add to dashboard Cite

Background: Hemorrhagic and ischemic magnetic resonance imaging lesions as well as the more recently described decrease in vasomotor reactivity have been suggested as possible biomarkers for cerebral amyloid angiopathy (CAA). Analyses of these markers have been primarily cross-sectional during the symptomatic phase of the disease, with little data on their longitudinal progression, particularly in the presymptomatic phase of the disease when it may be most responsive to treatment. We used the unique opportunity provided by studying Dutch-type hereditary cerebral amyloid angiopathy (D-CAA) to determine longitudinal progression of CAA biomarkers during the presymptomatic as well as the symptomatic phase of the disease. Methods: In this longitudinal case-control study, magnetic resonance imaging markers and cognitive performance were assessed at baseline and after ≈4 years in 10 presymptomatic and 6 symptomatic D-CAA mutation carriers and 20 control subjects. These magnetic resonance imaging markers included hemorrhagic and ischemic manifestations, measurements of cerebral blood flow, and vasomotor reactivity to visual stimulation. Results: In presymptomatic D-CAA mutations carriers, vasomotor reactivity showed a decline over time for blood-oxygen-level–dependent amplitude ( P =0.011) and prolongation of time to peak ( P <0.001). In contrast, no significant changes in hemorrhagic markers, ischemic markers, cerebral blood flow, and cognition were found. In symptomatic D-CAA mutation carriers, the number of intracerebral hemorrhages increased over the 4-year period ( P =0.007). Conclusions: Our findings indicate that in the presymptomatic phase of D-CAA, cerebrovascular reactivity measured by the blood-oxygen-level–dependent amplitude and time to peak to visual stimulation progressively worsens and can thus be regarded as a disease progression marker. In the symptomatic phase, the most salient marker of progression appears to be recurrent intracerebral hemorrhage.

show abstract

Section: Image Acquisitionmentioning

confidence: 99%

Longitudinal Progression of Magnetic Resonance Imaging Markers and Cognition in Dutch-Type Hereditary Cerebral Amyloid Angiopathy

Dijk

Lak

Berg-Huysmans

et al. 2022

Stroke

Self Cite

View full text Add to dashboard Cite

show abstract

“…Notwithstanding these limitations, the findings by Grangeon et al 7 on the diagnostic yield of each of the extensive MRI marker panel, and data on current CAA-ri diagnostic criteria accuracy, perhaps not serendipitously, are in line with the pragmatic diagnostic approach that other colleagues and I are using in routine practice when suspecting CAA-ri—one that often deviates from previously suggested criteria. The Table operationalizes this pragmatic diagnostic framework and revised criteria for CAA-ri intergrading most up to date imaging markers, as informed by the study of Grangeon et al 7 The intriguing role of inflammation in sporadic CAA more broadly remains a topic of ongoing investigation. 10…”

mentioning

confidence: 66%

“…A study by Grangeon et al 7 published in this issue of Neurology ® is timely because it addresses some fundamental gaps in CAA-ri diagnostics. In a retrospective study across 23 French centers, they compared a CAA-ri patient cohort (n = 104, pathologically proven or probable) with a cohort of patients with biopsy-positive primary angiitis of the CNS (PACNS, a CAA-ri differential) (n = 52).…”

mentioning

confidence: 99%