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Superficial siderosis in the general population.

M W Vernooij¹, M A Ikram, A Hofman

¹Department of Epidemiology, Erasmus MC UniversityMedical Center, 3015 CE Rotterdam, The Netherlands.

|July 22, 2009

Summary

Superficial siderosis was found in 0.7% of nondemented elderly individuals. All cases showed cerebral microbleeds, supporting a link between superficial siderosis and cerebral amyloid angiopathy (CAA).

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Area of Science:

Neurology
Radiology
Neuroimaging

Background:

Superficial siderosis, hemosiderin deposition in subpial brain layers, is rare.
Previous case studies suggest an association with cerebral amyloid angiopathy (CAA) and a potential role in Alzheimer disease (AD).
Prior diagnoses of superficial siderosis were based on overt clinical symptoms.

Purpose of the Study:

To investigate the prevalence of superficial siderosis in a general population of nondemented elderly individuals using brain MRI.
To explore the association between superficial siderosis and cerebral microbleeds, indicators of CAA.

Main Methods:

Brain MRI (T2*-weighted) was performed on 1,062 participants from the population-based Rotterdam Scan Study (mean age 69.6 years).
The presence, number, and location of cerebral microbleeds were assessed to identify potential CAA markers.

Main Results:

Superficial siderosis was detected in 7 individuals (0.7%) within the study cohort.
All individuals with superficial siderosis also exhibited cerebral microbleeds in lobar locations.
Microbleeds were consistently found in close proximity to superficial siderosis deposits.

Conclusions:

The findings provide indirect evidence supporting the hypothesized association between superficial siderosis and cerebral amyloid angiopathy (CAA).
Further longitudinal studies are required to determine if superficial siderosis serves as a marker for CAA severity or prognosis.