Document Detail


Prevalence of superficial siderosis in patients with cerebral amyloid angiopathy.
MedLine Citation:
PMID:  20421578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cerebral amyloid angiopathy (CAA) typically presents with lobar intracerebral macrohemorrhages (ICH) or microbleeds (MBs). Several case reports also found superficial siderosis (SS) in patients with CAA. We aimed to assess the value of SS for the in vivo diagnosis of CAA, and tested whether the inclusion of SS as a criterion alters the sensitivity and specificity of the Boston criteria for CAA-related hemorrhage.
METHODS: We retrospectively analyzed the T2*-weighted MRIs of 38 patients with histopathologically proven CAA and of 22 control patients with histopathologically proven non-CAA ICHs regarding the presence of ICHs, MBs, and SS. We compared the sensitivity and specificity of the classic Boston criteria to that of modified criteria, which included SS as a criterion.
RESULTS: ICHs were present in 71% of the patients with CAA, and in all control patients. MBs were found in 47.4% of patients with CAA and in 22.7% of controls. SS was detected in 60.5% of patients with CAA, but in none of the controls. The classic criteria had a sensitivity of 89.5% for CAA-related hemorrhage, while inclusion of SS increased their sensitivity to 94.7% (not significant). On the contrary, the specificity of the Boston criteria was 81.2% both for the classic and for the modified criteria.
CONCLUSIONS: Superficial siderosis (SS) occurs with high prevalence in cerebral amyloid angiopathy (CAA) and is rare in non-CAA forms of intracerebral hemorrhages. Thus, we propose that inclusion of SS in the Boston criteria might enhance their sensitivity for CAA-related hemorrhage without loss of specificity.
Authors:
J Linn; A Halpin; P Demaerel; J Ruhland; A D Giese; M Dichgans; M A van Buchem; H Bruckmann; S M Greenberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurology     Volume:  74     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-05-10     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1346-50     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / pathology
Cerebral Amyloid Angiopathy / complications*,  epidemiology*,  pathology
Female
Humans
Magnetic Resonance Imaging
Male
Prevalence
Retrospective Studies
Sensitivity and Specificity
Siderosis / complications*,  epidemiology*,  pathology
Grant Support
ID/Acronym/Agency:
K24NS056207/NS/NINDS NIH HHS; R01 AG026484/AG/NIA NIH HHS; R01AG021084/AG/NIA NIH HHS; R01AG026484/AG/NIA NIH HHS; R01NS042147/NS/NINDS NIH HHS; U54NS057405/NS/NINDS NIH HHS
Comments/Corrections
Comment In:
Neurology. 2010 Oct 26;75(17):1571; author reply 1571   [PMID:  20975060 ]

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