MRI phenotyping of underlying cerebral small vessel disease in mixed hemorrhage patients
| Autor: | Frank Schreiber, Emrah Düzel, Valentina Perosa, Andreas Charidimou, Stefan Vielhaber, Stefanie Schreiber, Vincent Scheumann, Michael Görtler, Cornelia Garz, Anne Assmann, Hans-Jochen Heinze, Christian Mawrin |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pathology
medicine.medical_specialty Siderosis Cerebral small vessel diseases Disease Vascular dementia 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid medicine Humans cardiovascular diseases 030212 general & internal medicine ddc:610 Perivascular space Cerebral Hemorrhage Intracerebral hemorrhage business.industry diagnostic imaging [Cerebral Hemorrhage] medicine.disease Superficial siderosis Magnetic Resonance Imaging Hyperintensity Cerebral Amyloid Angiopathy medicine.anatomical_structure Neurology Cerebral Small Vessel Diseases complications [Cerebral Small Vessel Diseases] complications [Cerebral Hemorrhage] cardiovascular system Neurology (clinical) Cerebral amyloid angiopathy diagnostic imaging [Cerebral Small Vessel Diseases] business 030217 neurology & neurosurgery MRI |
| Zdroj: | Journal of the neurological sciences 419, 117173 (2020). doi:10.1016/j.jns.2020.117173 |
| DOI: | 10.1016/j.jns.2020.117173 |
| Popis: | Objective To investigate underlying cerebral small vessel disease (CSVD) in patients with mixed cerebral hemorrhages patterns and phenotype them according to the contribution of the two most common sporadic CSVD subtypes: cerebral amyloid angiopathy (CAA) vs. hypertensive arteriopathy (HA). Methods Brain MRIs of patients with intracerebral hemorrhages (ICHs) and/or cerebral microbleeds (CMBs) were assessed for the full spectrum of CSVD markers using validated scales: ICHs, CMBs, cortical superficial siderosis (cSS), white matter hyperintensities, MRI-visible perivascular spaces (PVS). PVS predominance pattern was grouped as centrum-semiovale (CSO)-PVS predominance, basal-ganglia (BG)-PVS predominance, CSO-PVS and BG-PVS equality. Patients with mixed cerebral hemorrhages were classified into mixed CAA-pattern or mixed HA-pattern according to the existence of cSS and/or a CSO-PVS predominance pattern and comparisons were performed. Results We included 110 patients with CAA (strictly lobar ICHs/CMBs), 33 with HA (strictly deep ICHs/CMBs) and 97 with mixed lobar/deep ICHs/CMBs. Mixed patients were more similar to HA with respect to their MRI-CSVD markers, vascular risk profile and cerebrospinal fluid (CSF) measures. In the mixed patients, 33 (34%) had cSS, a CSO-PVS predominance pattern, or both, and were defined as mixed CAA-pattern cases. The mixed CAA-pattern patients were more alike CAA patients regarding their MRI-CSVD markers, CSF and genetic profile. Conclusion Our findings suggest that the heterogeneous group of patients with mixed cerebral hemorrhages distribution can be further phenotyped according to the predominant underlying CSVD. cSS presence and a CSO-PVS predominance pattern could serve as strongly suggestive markers of a contribution from CAA among patients with mixed hemorrhages. |
| Databáze: | OpenAIRE |
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