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High-resolution Structural Magnetic Resonance Imaging of the Human Subcortex In Vivo and Postmortem
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Amyloid Angiopathy in Brain Hemorrhage: A Postmortem Neuropathological-Magnetic Resonance Imaging Study

Celine Guidoux1,2,3, Jean-Jacques Hauw3, Isabelle F Klein4

  • 1INSERM LVTS (Laboratory for Vascular Translational Science) 1148 and Paris-Diderot University, Sorbonne Paris Cité, Paris, France.

Cerebrovascular Diseases (Basel, Switzerland)
|March 21, 2018
PubMed

Insights

Hypertension and cerebral amyloid angiopathy (CAA) often occur together in patients with intracerebral hemorrhage (ICH). Microbleeds, detected by MRI and confirmed by histology, were more frequent in patients with CAA.

Area of Science:

  • Neurology
  • Pathology
  • Radiology

Background:

  • Intracerebral hemorrhage (ICH) is often linked to hypertension and cerebral amyloid angiopathy (CAA).
  • Understanding the prevalence and overlap of these risk factors in ICH is crucial.
  • Investigating the association between CAA and cerebral microbleeds is important for patient outcomes.

Purpose of the Study:

  • To determine the autopsy prevalence of CAA in patients who died from ICH.
  • To assess the overlap between CAA, hypertension, and other risk factors in ICH patients.
  • To correlate CAA with the presence of cerebral microbleeds.

Main Methods:

  • Analysis of 81 consecutive autopsy brains from ICH patients.
  • Staining for CAA detection and comparison with age/sex-matched controls.
  • Postmortem MRI and histological analysis of microbleeds in 11 ICH brains.

Main Results:

  • Hypertension and CAA were present in 69.1% and 24.7% of ICH cases, respectively.
  • CAA prevalence was similar in non-hypertensive ICH cases and controls, but higher in hypertensive cases versus controls.
  • MRI detected 48 microbleeds, with all 5 CAA-positive brains having microbleeds, compared to 3/6 CAA-negative brains.

Conclusions:

  • Hypertension and CAA frequently coexist in intracerebral hemorrhage.
  • MRI-detected microbleeds, confirmed histologically, were twice as common in patients with CAA compared to those with hypertensive ICH.
Abstract

Keywords:
Amyloid angiopathyAutopsyBrain hemorrhageMagnetic resonance imagingMicrobleeds

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