大脑粉样血管病变中的发作:系统性审查和元分析
Brin E Freund1, Md Manjurul Islam Shourav1, Anteneh M Feyissa1
1Department of Neurology, Mayo Clinic, Jacksonville, FL.
Neurology. Clinical practice
|March 31, 2025
概括
大脑粉样性血管病变 (CAA) 与22.8%的发作患病率有关,CAA-ri和表面性 siderosis等特定疾病显著增加了风险. 需要进一步的研究来澄清CAA患者的发作类型和结果.
科学领域:
- 神经学 神经学
- 血管神经学 血管神经学
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 大脑粉样血管病变 (CAA) 是一种与发作风险增加相关的脑血管疾病.
- 现有的CAA和发作的研究是有限的,主要由病例报告和小系列组成,缺乏对异质人群的大规模研究.
- 缺乏关于CAA患者发作和的长期结局数据.
研究的目的:
- 为了阐明脑粉样血管病变 (CAA) 患者的发作总比率.
- 为了确定与CAA相关的特定病理,增加了发作的风险.
- 在CAA的背景下,审查关于发作和的现有文献.
主要方法:
- 进行了文章的系统审查,确定了1376篇文章.
- 48篇文章 (34个案例报告/系列,14个队列研究) 被纳入了审查.
- 发作和的患病率和相关性在异构的CAA队列和特定的子组中被分析.
主要成果:
- 在队列研究中,发作的总体患病率为22.8%,具有显著的异质性.
- 在异质队列中的患者中,发病被诊断在34.4%的患者中,急性症状发作 (ASyS) 在10.6%的患者中.
- 表面性 siderosis (SS) 和 CAA 与相关的炎症 (CAA-ri) 与/发作有显著的相关性. 皮层下arachnoid出血 (cSAH) 和急性叶膜内出血 (ICH) 也与有关.
结论:
- 与CAA中发作风险增加相关的特定临床病理实体包括cSAH,CAA-ri,SS和急性ICH.
- 在经过审查的文献中,急性症状性发作和的定义很差.
- 需要进一步的研究,以更好地了解各种CAA患者群体的发作类型,患病率和结果.
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