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Cerebellar hemorrhages in patients with cerebral amyloid angiopathy

P Gavriliuc1, J Molad2, N Yaghmour1

  • 1Departments of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Journal of the Neurological Sciences
|August 18, 2019
PubMed

Insights

Cerebellar involvement is common in cerebral amyloid angiopathy (CAA), often presenting as microbleeds. Clinical outcomes do not differ between patients with or without cerebellar involvement, suggesting MRI screening for CAA in cerebellar hemorrhage cases.

Area of Science:

  • Neurology
  • Neuroradiology

Background:

  • Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease primarily affecting the cerebral cortex.
  • The extent of cerebellar involvement in CAA remains unclear.

Purpose of the Study:

  • To investigate the prevalence and characteristics of cerebellar involvement in patients with cerebral amyloid angiopathy (CAA).
  • To compare clinical variables between CAA patients with and without cerebellar involvement.

Main Methods:

  • Prospective enrollment of intracerebral hemorrhage (ICH) patients undergoing magnetic resonance imaging (MRI).
  • Diagnosis of CAA using the Boston criteria and categorization of hemorrhage types (macro-hematoma or microbleeds).
  • Comparison of CAA patients with and without cerebellar involvement.

Main Results:

  • Cerebellar involvement was observed in 34% of CAA patients, predominantly as multiple microbleeds in the cerebellar cortex.
  • Patients with cerebellar involvement had a higher number of lobar microbleeds.
  • No significant differences in clinical variables (age, gender, risk factors, functional outcome, survival) were found between groups.

Conclusions:

  • Cerebellar involvement is a frequent finding in CAA, characterized by superficial microbleeds.
  • Clinical presentation and outcomes are similar in CAA patients with or without cerebellar involvement.
  • MRI screening for CAA is recommended for patients presenting with cerebellar ICH.
Abstract

Keywords:
Amyloid angiopathyCerebellumIntracerebral hemorrhage

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