Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage
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Henry Ford Health System Henry Ford Health System Henry Ford Health System Scholarly Commons Henry Ford Health System Scholarly Commons Detroit Stroke Conference 2019 Detroit Stroke Conference 11-1-2019 Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage Mohammed Rehman Henry Ford Health System, [email protected] Follow this and additional works at: https://scholarlycommons.henryford.com/detstrokeconf2019 Recommended Citation Recommended Citation Rehman, Mohammed, "Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage" (2019). Detroit Stroke Conference 2019. 3. https://scholarlycommons.henryford.com/detstrokeconf2019/3 This Poster is brought to you for free and open access by the Detroit Stroke Conference at Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Detroit Stroke Conference 2019 by an authorized administrator of Henry Ford Health System Scholarly Commons.
Transcript of Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage
Henry Ford Health System Henry Ford Health System
Henry Ford Health System Scholarly Commons Henry Ford Health System Scholarly Commons
Detroit Stroke Conference 2019 Detroit Stroke Conference
11-1-2019
Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage
Mohammed Rehman Henry Ford Health System, [email protected]
Follow this and additional works at: https://scholarlycommons.henryford.com/detstrokeconf2019
Recommended Citation Recommended Citation Rehman, Mohammed, "Cerebral Amyloid Angiopathy and Intracerebral Hemorrhage" (2019). Detroit Stroke Conference 2019. 3. https://scholarlycommons.henryford.com/detstrokeconf2019/3
This Poster is brought to you for free and open access by the Detroit Stroke Conference at Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Detroit Stroke Conference 2019 by an authorized administrator of Henry Ford Health System Scholarly Commons.
CEREBRAL AMYLOID ANGIOPATHY AND ICH –A SYSTEMATIC REVIEWMOHAMMED F REHMAN, DO
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Objectives
• Definition of CAA as a disease
• Key clinical/MRI signatures
• Implications for treatments, BP, OAC etc.
• latest developments, current trends – No RCTs to
date.
Key Take Home Message
•MRI is crucial when CAA is suspected
– For diagnosis
– For prognosis
• Cortical superficial siderosis – driver of
bleeding
• CAA is not only about hemorrhage –
ischemic Lesions, encephalopathies,
inflammation/angiitis.
What is CAA
Operational definitions – 3 intersecting levels:
1. Neuropathological level
2. Key clinical presentations / Boston criteria
❑ Spontaneous lobar ICH (10-30% of all ICH)
❑ CAA non-ICH syndromes
“Amyloid spells”, acute cSAH
dementia
CAA related vaculopathies
3. MRI markers and other biomarkers
❑ Early diagnosis – incidental finding
Cerebral Amyloid Angiopathy
• Disease of the elderly
(~50% of ICH in >80)
• Deposition of amyloid
protein in
media/adventitia of small
cortical arteries,
arterioles and capillaries
• Cortex and cerebellum
What is CAA?Pathologically common, clinically relevant
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CAA pathophysiology: complex, poorly understood
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Brain, Volume 140, Issue 7, July 2017, Pages 1829–1850, https://doi.org/10.1093/brain/awx047
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Figure 5 Suggested heuristic schematic of the possible different
phenotypes of CAA and directions in the expression of ...
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Heriditary CAA Spectrum
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CAA diagnosis – Boston Criteria
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A schematic representation of the spectrum of haemorrhagic and ischaemic manifestations of sporadic cerebral amyloid angiopathy, visible on MRI.
Andreas Charidimou et al. J Neurol Neurosurg Psychiatry 2012;83:124-137
©2012 by BMJ Publishing Group Ltd
Why is CAA clinically relevant?
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Why CAA as disease target
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Our Team
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Neurointensivists
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Neuro ICU (C-6West)
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