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Original Paper

Lobar Brain Hemorrhages and White Matter Changes: Clinical, Radiological and Laboratorial Profiles

Maia L.F.a · Vasconcelos C.b · Seixas S.c · Magalhães R.d · Correia M.a

Author affiliations

Departments of aNeurology and bNeuroradiology, Hospital Geral Santo António, cInstituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP) and dPopulation Study Department, ICBAS, UP, Porto, Portugal

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Cerebrovasc Dis 2006;22:155–161

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 14, 2005
Accepted: February 09, 2006
Published online: July 14, 2006
Issue release date: July 2006

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Background: White matter changes have several histopathologic correlates including cerebral amyloid angiopathy (CAA). The aim of this study was to characterize the clinical, laboratorial and neuroradiological profile of a CAA-related lobar hemorrhages case series. Methods: A cohort of 50 consecutive patients with cerebral lobar hemorrhages was studied and clinical, radiological data and ApoE polymorphisms were analyzed. White matter changes were graded and microbleeds were characterized according to number and location using T2* MRI. Results: A statistically significant association was found between the prestroke cognitive performance and poststroke dementia and between hemorrhage volume and mortality. More severe white matter changes were found in probable CAA when comparing to possible CAA. The most prominent white matter lesions are associated with the presence and the number of microbleeds. The frequency of APOE υ2 and υ4 alleles was higher in this cohort when compared to a Northern Portuguese population. Conclusion: White matter changes are frequent in lobar hemorrhage patients and are associated with cortical microbleeds, the radiological hallmark of CAA. Therefore, white matter changes may be the sole phenotype of CAA and, potentially, involved in the pre-stroke cognitive impairment presented by the patients, which are genetically distinct from the population in general.

© 2006 S. Karger AG, Basel


References

  1. Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjogren M, Wallin A, Ader H, Leys D, Pantoni L, Pasquier F, Erkinjuntti T, Scheltens P, European Task Force on Age-Related White Matter Changes: A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke 2001;32:1318–1322.
  2. Haglund M, Englund E: Cerebral amyloid angiopathy, white matter lesions and Alzheimer encephalopathy – a histopathological assessment. Dement Geriatr Cogn Disord 2002;14:161–166.
  3. Greenberg SM: Cerebral amyloid angiopathy and vessel dysfunction (review). Cerebrovasc Dis 2002;13(suppl 2):42–47.
  4. The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group: A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. Ann Neurol 1997;42:857–865.
  5. EAFT (European Atrial Fibrillation Trial) Study Group: Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993;342:1255–1262.
  6. Gorter JW: Major bleeding during anticoagulation after cerebral ischemia: patterns and risk factors. Stroke Prevention In Reversible Ischemia Trial (SPIRIT). European Atrial Fibrillation Trial (EAFT) study groups. Neurology 1999;53:1319–1327.
  7. Smith EE, Rosand J, Knudsen KA, Hylek EM, Greenberg SM: Leukoaraiosis is associated with warfarin-related hemorrhage following ischemic stroke. Neurology 2002;59:193–197.
  8. Vinters HV: Cerebral amyloid angiopathy: a critical review. Stroke 1987;18:311–324. Review.
  9. O’Donnell HC, Rosand J, Knudsen KA, Furie KL, Segal AZ, Chiu RI, Ikeda D, Greenberg SM: Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage. N Engl J Med 2000;342:240–245.
  10. Yamada M: Cerebral amyloid angiopathy: an overview. Neuropathology 2000;20:8–22.
  11. Maia LF, Botelho L, Correia M: Commentary on ‘subcortical hematoma caused by cerebral amyloid angiopathy: does the first evidence of hemorrhage occur in the subarachnoid space?’ (Neuropathology 2003;23, 254–261). Neuropathology 2004;24:354–355.
  12. Pfeifer LA, White LR, Ross GW, Petrovitch H, Launer LJ: Cerebral amyloid angiopathy and cognitive function: the HAAS autopsy study. Neurology 2002;58:1629–1634.
  13. Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR: Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA 1997;277:813–817.
  14. Honig LS, Tang MX, Albert S, Costa R, Luchsinger J, Manly J, Stern Y, Mayeux R: Stroke and the risk of Alzheimer disease. Arch Neurol 2003;60:1707–1712.
  15. Vermeer SE, Hollander M, van Dijk EJ, Hofman A, Koudstaal PJ, Breteler MM; Rotterdam Scan Study: Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study. Stroke 2003;34:1126–1129.
  16. Knudsen KA, Rosand J, Karluk D, Greenberg SM: Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Neurology 2001;56:537–539.
  17. Jorm AF: A short form of the informant questionnaire on cognitive decline of the elderly (IQCODE): development and cross-validation. Psychol Med 1994;24:145–153.
  18. Jorm AF: The informant questionnaire on cognitive decline of the elderly (IQCODE): a review. Int Psychogeriatr 2004;16:1–19.
    External Resources
  19. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, et al: Vascular dementia: diagnostic criteria for research studies: report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  20. Seixas S, Trovoada MJ, Rocha J: Haplotype analysis of the apolipoprotein E and apolipoprotein C1 loci in Portugal and São Tomé e Príncipe (Gulf of Guinea): linkage disequilibrium evidence that APOE*4 is the ancestral APOE allele. Hum Biol 1999;71:1001–1008.
  21. Kwak R, Kadoya S, Suzuki T: Factors affecting the prognosis in thalamic hemorrhage. Stroke 1983;14:493–500.
  22. Law S, Wolfson C: Validation of a French version of an informant-based questionnaire as a screening test for Alzheimer’s disease. Br J Psychiatry 1995;167:541–544.
  23. Henon H, Pasquier F, Durieu I, Godefroy O, Lucas C, Lebert F, Leys D: Preexisting dementia in stroke patients: baseline frequency, associated factors, and outcome. Stroke 1997;28:2429–2436.
  24. Guo SW, Thompson EA: Performing the exact test of Hardy-Weinberg proportion for multiple alleles. Biometrics 1992;48:361–372.
  25. Rousset F, Raymond M: Testing heterozygote excess and deficiency. Genetics 1995;140:1413–1419.
  26. Goudet J, Raymond M, de Meeus T, Rousset F: Testing differentiation in diploid populations. Genetics 1996;144:1933–1940.
  27. Smith EE, Gurol ME, Eng JA, Engel CR, Nguyen TN, Rosand J, Greenberg SM: White matter lesions, cognition, and recurrent hemorrhage in lobar intracerebral hemorrhage. Neurology 2004;63:1606–1612.
  28. Tanaka A, Ueno Y, Nakayama Y, Takano K, Takebayashi S: Small chronic hemorrhages and ischemic lesions in association with spontaneous intracerebral hematomas. Stroke 1999;30:1637–1642.
  29. Greenberg SM, Eng JA, Ning M, Smith EE, Rosand J: Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage. Stroke 2004;35:1415–1420.
  30. Werring DJ, Frazer DW, Coward LJ, Losseff NA, Watt H, Cipolotti L, Brown MM, Jager HR: Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI. Brain 2004;127:2265–2275.
  31. Bornebroek M, Van Buchem MA, Haan J, Brand R, Lanser JB, de Bruine FT, Roos RA: Hereditary cerebral hemorrhage with amyloidosis-Dutch type: better correlation of cognitive deterioration with advancing age than with number of focal lesions or white matter hyperintensities. Alzheimer Dis Assoc Disord 1996;10:224–231.
  32. Greenberg SM, Shin Y, Grabowski TJ, Cooper GE, Rebeck GW, Iglesias S, Chapon F, Tournier-Lasserve E, Baron JC: Hemorrhagic stroke associated with the Iowa amyloid precursor protein mutation. Neurology 2003;60:1020–1022.
  33. Walker DA, Broderick DF, Kotsenas AL, Rubino FA: Routine use of gradient-echo MRI to screen for cerebral amyloid angiopathy in elderly patients. AJR Am J Roentgenol 2004;182:1547–1550.
  34. Inagawa T, Ohbayashi N, Takechi A, Shibukawa M, Yahara K: Primary intracerebral hemorrhage in Izumo City, Japan: incidence rates and outcome in relation to the site of hemorrhage. Neurosurgery 2003;53:1283–1297; discussion 1297–1298.
  35. Wong KS, Chan YL, Liu JY, Gao S, Lam WW: Asymptomatic microbleeds as a risk factor for aspirin-associated intracerebral hemorrhages. Neurology 2003;60:511–513.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 14, 2005
Accepted: February 09, 2006
Published online: July 14, 2006
Issue release date: July 2006

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED


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