Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander?
Goal: Cerebral amyloid angiopathy (CAA) is a frequent cause of atypical intracerebral hemorrhage (ICH) in the elderly. Stroke risk factors such as arterial hypertension (AHT), atrial fibrillation (AFib), diabetes mellitus (DM), and renal dysfunction (RD) are increasingly apparent in these patients....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.676931/full |
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| author | Andrea Wagner Jonas Maderer Sibylle Wilfling Johanna Kaiser Mustafa Kilic Ralf A. Linker Karl-Michael Schebesch Felix Schlachetzki |
| author_facet | Andrea Wagner Jonas Maderer Sibylle Wilfling Johanna Kaiser Mustafa Kilic Ralf A. Linker Karl-Michael Schebesch Felix Schlachetzki |
| author_sort | Andrea Wagner |
| collection | DOAJ |
| description | Goal: Cerebral amyloid angiopathy (CAA) is a frequent cause of atypical intracerebral hemorrhage (ICH) in the elderly. Stroke risk factors such as arterial hypertension (AHT), atrial fibrillation (AFib), diabetes mellitus (DM), and renal dysfunction (RD) are increasingly apparent in these patients. In this retrospective study, we analyzed the presence of these stroke risk factors in different initial CAA presentations comprising cerebral microbleeds (CMB), acute ischemic stroke (AIS), cortical superficial hemosiderosis (cSS), or lobar ICH (LICH) and evaluated their influence on the initial clinical presentation of patients with CAA.Material and Methods: We identified patients with at least possible CAA defined by the modified Boston criteria admitted to the Department of Neurology or Neurosurgery from 2002 to 2018.Findings: In the overall cohort of 209 patients, we analyzed the correlation between the number of stroke risk factors and the initial clinical presentation of patients with CAA and could show the high multimorbidity of the collective. There are large differences between the subgroups with different initial clinical presentations, e.g., patients with CMB as initial CAA presentation have the highest number of cerebrovascular risk factors and recurrent AIS, whereas AFib is more frequent in the Neurosurgery Department.Conclusion: There is a distinct overlap between the subgroups of CAA manifestations and stroke risk factors that need to be verified in larger patient collectives. Since these comorbidities are likely to influence the clinical course of CAA, they represent possible targets for secondary prevention until specific treatment for CAA becomes available. |
| first_indexed | 2024-12-22T12:51:36Z |
| format | Article |
| id | doaj.art-52dd8c19f1d948018ecb2d0fce581af1 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-22T12:51:36Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-52dd8c19f1d948018ecb2d0fce581af12022-12-21T18:25:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-07-011210.3389/fneur.2021.676931676931Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander?Andrea Wagner0Jonas Maderer1Sibylle Wilfling2Johanna Kaiser3Mustafa Kilic4Ralf A. Linker5Karl-Michael Schebesch6Felix Schlachetzki7Department of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurosurgery, University Hospital Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyGoal: Cerebral amyloid angiopathy (CAA) is a frequent cause of atypical intracerebral hemorrhage (ICH) in the elderly. Stroke risk factors such as arterial hypertension (AHT), atrial fibrillation (AFib), diabetes mellitus (DM), and renal dysfunction (RD) are increasingly apparent in these patients. In this retrospective study, we analyzed the presence of these stroke risk factors in different initial CAA presentations comprising cerebral microbleeds (CMB), acute ischemic stroke (AIS), cortical superficial hemosiderosis (cSS), or lobar ICH (LICH) and evaluated their influence on the initial clinical presentation of patients with CAA.Material and Methods: We identified patients with at least possible CAA defined by the modified Boston criteria admitted to the Department of Neurology or Neurosurgery from 2002 to 2018.Findings: In the overall cohort of 209 patients, we analyzed the correlation between the number of stroke risk factors and the initial clinical presentation of patients with CAA and could show the high multimorbidity of the collective. There are large differences between the subgroups with different initial clinical presentations, e.g., patients with CMB as initial CAA presentation have the highest number of cerebrovascular risk factors and recurrent AIS, whereas AFib is more frequent in the Neurosurgery Department.Conclusion: There is a distinct overlap between the subgroups of CAA manifestations and stroke risk factors that need to be verified in larger patient collectives. Since these comorbidities are likely to influence the clinical course of CAA, they represent possible targets for secondary prevention until specific treatment for CAA becomes available.https://www.frontiersin.org/articles/10.3389/fneur.2021.676931/fullcerebral amyloid angiopathyintracerebral hemorrhagelong term outcomerisk factors (cardiovascular) comorbiditiescomputer tomographymagnetic resonance imaging |
| spellingShingle | Andrea Wagner Jonas Maderer Sibylle Wilfling Johanna Kaiser Mustafa Kilic Ralf A. Linker Karl-Michael Schebesch Felix Schlachetzki Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? Frontiers in Neurology cerebral amyloid angiopathy intracerebral hemorrhage long term outcome risk factors (cardiovascular) comorbidities computer tomography magnetic resonance imaging |
| title | Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? |
| title_full | Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? |
| title_fullStr | Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? |
| title_full_unstemmed | Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? |
| title_short | Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander? |
| title_sort | cerebrovascular risk factors in possible or probable cerebral amyloid angiopathy modifier or bystander |
| topic | cerebral amyloid angiopathy intracerebral hemorrhage long term outcome risk factors (cardiovascular) comorbidities computer tomography magnetic resonance imaging |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.676931/full |
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