Related Experiment Video
Updated: Mar 31, 2026
Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats
Published on: October 17, 2018
Reduction of microbleeds by immunosuppression in a patient with Aβ-related vascular inflammation
Andreas Traschütz1, Theophilos Tzaridis1, Arndt-Hendrik Penner1
1Departments of Neurology (A.T., T.T., M.T.H.), Neuroradiology (A.-H.P., E.H.), and Neuropathology (K.K.), University of Bonn, Germany; Department of Neuroradiology (H.U.), University of Freiburg, Germany; and German Center for Neurodegenerative Disease (M.T.H.), Bonn, Germany.
Objective:
To investigate whether the occurrence or clearance of microhemorrhages in cerebral amyloid angiopathy (CAA)-related vascular inflammation can be modified by immunosuppressive treatment.
Methods:
Clinical and radiologic follow-up for more than 5 years of a patient with histopathologically confirmed CAA-related vascular inflammation treated with a prolonged and tapered regimen of IV cyclophosphamide and oral steroids.
Results:
Under long-term immunosuppressive treatment, a reduced number of cortical micobleeds was observed on repeat MRIs because of both the prevention of new microbleeds and the clearance of those existing at baseline.
Conclusions:
Sustained immunosuppression should be considered and systematically investigated as a treatment option for cortical microbleeds in CAA and related inflammatory phenotypes.
Classification Of Evidence:
This study provides Class IV evidence. This is a single observational study without controls.
Insights
Immunosuppressive treatment may reduce and clear microhemorrhages in cerebral amyloid angiopathy (CAA)-related vascular inflammation. Long-term therapy showed fewer new and existing cortical microbleeds in a patient with CAA.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Cerebral amyloid angiopathy (CAA) is associated with vascular inflammation and microhemorrhages.
- The potential for modifying microhemorrhage occurrence or clearance with treatment is not well understood.
Purpose of the Study:
- To investigate if immunosuppressive treatment can alter microhemorrhage dynamics in CAA-related vascular inflammation.
Main Methods:
- A single patient with histopathologically confirmed CAA-related vascular inflammation underwent over 5 years of clinical and radiologic follow-up.
- Treatment involved a prolonged, tapered regimen of intravenous cyclophosphamide and oral steroids.
Main Results:
- Long-term immunosuppression led to a decrease in cortical microbleeds.
- This reduction was attributed to both the prevention of new microhemorrhages and the clearance of pre-existing ones.
Conclusions:
- Sustained immunosuppression shows promise as a therapeutic strategy for managing cortical microbleeds in CAA.
- Further systematic investigation of immunosuppression for inflammatory CAA phenotypes is warranted.
