Hémorragie méningée focale et angiopathie amyloïde cérébrale : une association non fortuite

Brunot, S.; Fromont, Agnès; Ricolfi, F.; Moreau, Thibault; Giroud, Maurice

doi:10.1016/j.neurol.2009.01.037

Cited by 14 publications

(7 citation statements)

References 35 publications

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“…However, a combination of transient paresthesias and focal SAH has also been observed with cerebral venous thrombosis [20]. In contrast, in subjects >60 years old, CAA is the most frequent cause of this syndrome [11,19,21]. Several cases of pathologically confirmed CAA with such a clinical picture have been reported [7,13].…”

Section: Discussionmentioning

confidence: 99%

Focal Cortical Subarachnoid Hemorrhage Revealed by Recurrent Paresthesias: A Clinico-Radiological Syndrome Strongly Associated with Cerebral Amyloid Angiopathy

et al. 2013

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Background: Focal subarachnoid hemorrhage (SAH) is often revealed by transient and recurrent focal neurological episodes. This cause is important to identify because it carries a high risk of intracerebral hemorrhage (ICH). We report the clinical, imaging and prognostic data of 17 patients with focal SAH revealed by short episodes of paresthesias mimicking transient ischemic attacks. Methods: The medical records and imaging data of patients with focal acute SAH at the cerebral convexity and at least one episode of focal paresthesia having attended the Neurology Department of Caen University Hospital in the last 10 years were retrospectively reviewed. Hemorrhagic lesions, ischemic lesions, cerebral microbleeds (CMBs), superficial siderosis, white matter changes (leukoaraiosis) and modified Boston criteria for cerebral amyloid angiopathy (CAA) were assessed. All patients or relatives were contacted after a median delay of 16 months in order to seek for new events (death, stroke, recurrent focal symptoms, ICH and dementia) that occurred since hospital discharge. Results: Seventeen patients (12 men) aged 69-96 years were identified. All but 1 had multiple, repeated, stereotyped and brief attacks of paresthesias, associated in some of them with motor and/or speech difficulties, but only 1 had a headache. SAHs were seen on CT scans in 15/17 patients and on T2* gradient-echo magnetic resonance imaging (MRI) in all patients. They were multiple SAHs in 14/17 patients, including at least 1 SAH in the central or pre- or postcentral sulcus contralateral to the symptoms in all patients. Five patients had punctate cortical hyperintensities on diffusion-weighted MRI. Eleven patients had CMBs, and 4 of them had more than 5 CMBs. Seven patients met the modified Boston criteria for probable and 10 for possible CAA. At follow-up, 5 patients had a subsequent ICH, 4 of whom had received antithrombotic treatments. Five patients died (1 from ICH). Six patients developed dementia. Conclusion: The combination of transient, repeated and stereotyped attacks of unilateral paresthesias with a contralateral sulcal SAH seems to preferentially occur in elderly people and is often indicative of CAA.

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Section: Discussionmentioning

confidence: 99%

Focal Cortical Subarachnoid Hemorrhage Revealed by Recurrent Paresthesias: A Clinico-Radiological Syndrome Strongly Associated with Cerebral Amyloid Angiopathy

et al. 2013

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“…Cerebral amyloid angiopathy has been described as an etiology for transient neurological deficits and focal subarachnoid hemorrhage as one of its less common presentations and is possibly an underestimated cause [3]. Some case series describe subsequent lobar hemorrhages following cortical subarachnoid hemorrhage [4]. One study reports 2 patients who 20-33 days after initially presenting with isolated subarachnoid hemorrhage developed large subcortical hematomas [5].…”

Section: Discussionmentioning

confidence: 99%

Cortical Vein Thrombosis as a Mimic for Isolated Cortical Subarachnoid Hemorrhage and Transient Ischemic Attack

Morris¹,

Fisher²,

Carandang³

2010

Case Rep Neurol

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Isolated cortical subarachnoid hemorrhage is rare and poorly understood. Differential diagnoses and proposed pathophysiology vary widely and the diagnostic work-up for these patients who present with transient ischemic attack-like episodes and characteristic imaging findings is still unclear. We report a case of isolated subarachnoid hemorrhage and transient neurologic deficits due to isolated cortical vein thrombosis that was not detected by noninvasive tests. A 75-year-old woman with a history of a lobar intracerebral hemorrhage presented to the Academic Medical Center with sudden-onset transient left upper extremity weakness. Head CT showed a linear hyperdensity in the right precentral gyrus suggestive of isolated subarachnoid hemorrhage. MRI showed susceptibility in the corresponding area. CT angiogram and MRV showed no evidence of a venous thrombosis. The main outcome measures were results of computerized tomography and CT angiogram, magnetic resonance parenchymal and vascular imaging, angiography findings and clinical follow-up at 3 months. Cortical vein thrombosis was detected on conventional angiography. MRI was negative for microhemorrhages. The patient was anticoagulated and had no recurrences of her symptoms. We conclude that cortical vein thrombosis can present as isolated subarachnoid hemorrhage and transient ischemic attack-like episodes and may require angiography for definitive diagnosis.

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“…Man geht davon aus, dass akute fSAB und die SS für transiente neurologische Symptome, die bei CAA-Patienten auftreten können, verantwortlich sind (31,(55)(56)(57). Hierbei handelt es sich um sehr stereotype, transiente Defizite, meist eine transiente Hemiparese oder Hemihypästhesie.…”

Section: Sporadische Zerebrale Amyloidangiopathieunclassified

“…Hierbei handelt es sich um sehr stereotype, transiente Defizite, meist eine transiente Hemiparese oder Hemihypästhesie. Diese Phänomene wurden in der Literatur uneinheitlich als "TIA-ähnlich", "auraähnlich", "migräneartig" oder als fokale Anfälle beschrieben (31,(55)(56)(57). Die akuten fSAB, die bei diesen Patienten nachgewiesen werden, betreffen meist den Sulcus centralis (▶Abb.…”

Section: Sporadische Zerebrale Amyloidangiopathieunclassified

“…Auf T2*-GRE-Sequenzen zeigt sich bei den betroffenen Patienten oft eine deutlich über die akute fSAB hinaus gehende SS. Dies bedeutet, dass die akuten, symptomatischen fSAB nur die Spitze des Eisbergs darstellen und legt nahe, dass die scheinbare Prädelektion für den Sulcus centralis aus einem Bias resultiert (57). Fokale SAB in anderen, weniger eloquenten, kortikalen Regionen sind wahrscheinlich klinisch oligosymptomatisch und werden daher nicht in der akuten Phase erfasst (▶Abb.…”

Section: Sporadische Zerebrale Amyloidangiopathieunclassified

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MRT bei zerebralen Mikroangiopathien

Linn¹

2013

Nervenheilkunde

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ZusammenfassungUnter einer zerebralen Mikroangiopathie (ZMA) versteht man Erkrankungen der kleinen hirnversorgenden Gefäße, die für ca. 20 bis 30% aller ischämischen Schlaganfälle verantwortlich sind. Während einige ZMA ausschließlich die zerebralen Gefäße betreffen, handelt es sich bei anderen Erkrankungen um Systemerkrankungen, die zu extrakraniellen Manifestationen führen können. Eine einheitliche Klassifikation der ZMA existiert in der Literatur nicht. Sinnvoll ist die Unterscheidung zwischen den häufigen erworbenen und den überwiegend sehr seltenen, angeborenen ZMA. In dieser Arbeit werden charakteristische MRT-Befunde, die bei allen Formen der ZMA in mehr oder weniger starker Ausprägung und Lokalisation gefunden werden, dargestellt. Im Anschluss werden spezifische bildgebende Charakteristika der wichtigsten Formen der ZMA, das heißt, der degenerativen Mikroangiopathie (DMA), der zerebralen Amyloidangiopathie (CAA), der CADASIL-Erkrankung, des Morbus Fabry, der hereditären Amyloidangiopathien und der COL4A1-assoziierten, zerebrale Mikroangiopathien, erläutert.

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Hémorragie méningée focale et angiopathie amyloïde cérébrale : une association non fortuite

Cited by 14 publications

References 35 publications

Focal Cortical Subarachnoid Hemorrhage Revealed by Recurrent Paresthesias: A Clinico-Radiological Syndrome Strongly Associated with Cerebral Amyloid Angiopathy

Focal Cortical Subarachnoid Hemorrhage Revealed by Recurrent Paresthesias: A Clinico-Radiological Syndrome Strongly Associated with Cerebral Amyloid Angiopathy

Cortical Vein Thrombosis as a Mimic for Isolated Cortical Subarachnoid Hemorrhage and Transient Ischemic Attack

MRT bei zerebralen Mikroangiopathien

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