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Updated: Jan 24, 2026
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Visualization of Amyloid β Deposits in the Human Brain with Matrix-assisted Laser Desorption/Ionization Imaging Mass Spectrometry
Published on: March 7, 2019
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Cerebellar Microbleed Distribution Patterns and Cerebral Amyloid Angiopathy
Marco Pasi1, Thanakit Pongpitakmetha2,1, Andreas Charidimou1
1Hemorrhagic Stroke Research Program, Department of Neurology, J. Philip Kistler Stroke Research Center (M.P., T.P., A.C., S.D.S., L.X., A.D.W., A.V., M.E.G., S.M.G.), Massachusetts General Hospital, Harvard Medical School, Boston.
Stroke
|June 5, 2019
Summary
Superficial cerebellar microbleeds (CMBs) are common in patients with intracerebral hemorrhage and strongly indicate cerebral amyloid angiopathy (CAA). Deep or mixed CMB patterns are linked to other causes of deep intracerebral hemorrhage.
Area of Science:
- Neurology
- Neuroradiology
- Pathology
Background:
- Hematoma location in the cerebellum can indicate small vessel disease type.
- Cerebral amyloid angiopathy (CAA) and non-amyloid small vessel disease are distinct entities.
- The association between cerebellar cerebral microbleeds (CMBs) location and CAA is not well understood.
Purpose of the Study:
- To investigate if cerebellar CMBs restricted to superficial regions are associated with clinically diagnosed and pathology-verified CAA.
- To test the hypothesis linking superficial cerebellar CMBs to CAA.
Main Methods:
- Magnetic resonance imaging (MRI) including susceptibility-weighted imaging was used for 307 spontaneous intracerebral hemorrhage (ICH) patients.
- Cerebellar CMB patterns were categorized as strictly superficial, deep, or mixed using a topographical template.
- Neuropathology data for CAA was available for 36 ICH patients with cerebellar CMBs.
Main Results:
- Cerebellar CMBs were found in 44% of ICH patients.
- A superficial CMB pattern was observed in 63% of patients with cerebellar CMBs.
- Strictly superficial cerebellar CMBs were associated with probable CAA-ICH (OR, 1.6) and pathologically verified CAA (96% vs. 25%).
Conclusions:
- Cerebellar CMBs are common in ICH patients and frequently located in superficial regions.
- A superficial distribution of cerebellar CMBs is a significant indicator of cerebral amyloid angiopathy.
- This finding aids in differentiating small vessel disease types based on CMB patterns.
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