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Related Experiment Video

Updated: Jan 27, 2026

Visualization of Cortical Modules in Flattened Mammalian Cortices
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Cortical Superficial Siderosis Evolution.

Andreas Charidimou1, Gregoire Boulouis1, Li Xiong1

  • 1From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (A.C., G.B., L.X., M.P., D.R., A.A., K.M.S., J.R., M.E.G., A.V., S.M.G.).

Stroke
|March 15, 2019
PubMed
Summary
This summary is machine-generated.

Cortical superficial siderosis progression is a significant predictor of increased risk for lobar intracerebral hemorrhage in patients with cerebral amyloid angiopathy. This finding highlights cSS evolution as a potential biomarker for disease progression and hemorrhage risk assessment.

Keywords:
cerebral amyloid angiopathycerebral hemorrhagedisease progressionmagnetic resonance imagingsiderosis

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Area of Science:

  • Neurology
  • Radiology
  • Clinical Medicine

Background:

  • Cerebral amyloid angiopathy (CAA) is a common cause of spontaneous lobar intracerebral hemorrhage (ICH) in older adults.
  • Cortical superficial siderosis (cSS), indicative of microhemorrhages, is frequently observed in CAA.
  • The prognostic value of cSS progression in CAA patients without baseline ICH remains unclear.

Purpose of the Study:

  • To investigate the progression of cortical superficial siderosis (cSS) in patients with probable cerebral amyloid angiopathy (CAA).
  • To determine the clinical relevance of cSS progression for predicting incident lobar intracerebral hemorrhage (ICH) risk.
  • To identify predictors of cSS progression in a cohort of CAA patients.

Main Methods:

  • Analysis of a single-center cohort of 118 patients meeting modified Boston criteria for probable CAA.
  • Magnetic resonance imaging (MRI) was performed at baseline and during follow-up to assess cSS progression.
  • Prospective follow-up for incident symptomatic ICH, with risk analyzed using Cox proportional hazard models.

Main Results:

  • cSS progression was detected in 28% of patients over a median follow-up of 2.2 years.
  • Baseline cSS presence, particularly disseminated cSS, and new lobar microbleeds independently predicted cSS progression.
  • cSS progression independently predicted an increased risk of symptomatic ICH (HR, 3.76; P=0.010).

Conclusions:

  • Cortical superficial siderosis (cSS) evolution is a significant predictor of disease progression and symptomatic ICH risk in probable cerebral amyloid angiopathy (CAA).
  • cSS progression may serve as a valuable biomarker for risk stratification in CAA patients.
  • These findings support the use of cSS evolution as a candidate biomarker in clinical studies and trials for CAA.