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Occipital Cortical Calcifications in Cerebral Amyloid Angiopathy
- Source :
- Stroke, 52(5), 1851-1855. LIPPINCOTT WILLIAMS & WILKINS
- Publication Year :
- 2021
-
Abstract
- Background and Purpose: Cortical calcifications have been reported in patients with cerebral amyloid angiopathy (CAA), although their prevalence and pathophysiology are unknown. We investigated the frequency of calcifications on computed tomography, their association with intracerebral hemorrhage (ICH) and their coexistence with a striped pattern of the occipital cortex reflecting microcalcifications on ultra-high-field 7T-magnetic resonance imaging in Dutch-type hereditary CAA (D-CAA) and sporadic CAA. Methods: We included D-CAA mutation carriers with a proven APP (amyloid precursor protein) mutation or ≥1 lobar ICH and ≥1 first-degree relative with D-CAA and sporadic CAA patients with probable CAA according to the modified Boston criteria. D-CAA carriers were regarded symptomatic when they had a history of symptomatic ICH. We assessed the presence, location, and progression of calcifications and their association with ICH and the striped occipital cortex. Results: We found cortical calcifications in 15/81 (19% [95% CI, 11–29]) D-CAA mutation carriers (15/69 symptomatic and 0/12 presymptomatic) and in 1/59 (2% [95% CI, 0–9]) sporadic CAA patients. Calcifications were all bilateral located in the occipital lobes. In 3/15 (20%) of the symptomatic D-CAA patients the calcifications progressed over a period up to 10 years. There was evidence of an association between cortical calcifications and new ICH development (hazard ratio, 7.1 [95% CI, 0.9–54.9], log-rank P =0.03). In 7/25 D-CAA symptomatic carriers in whom a 7T-magnetic resonance imaging was performed, a striped pattern of the occipital cortex was present; in 3/3 (100%) of those with calcifications on computed tomography and 4/22 (18%) of those without calcifications. Conclusions: Occipital cortical calcifications are frequent in D-CAA but seem to be rare in sporadic CAA. Their absence in presymptomatic carriers and their association with ICH might suggest that they are a marker for advanced CAA. Cortical calcifications on computed tomography seem to be associated with the striped occipital cortex on 7T-magnetic resonance imaging which may possibly represent an early stage of calcification.
- Subjects :
- Male
Pathology
medicine.medical_specialty
prevalence
030204 cardiovascular system & hematology
03 medical and health sciences
Amyloid beta-Protein Precursor
0302 clinical medicine
Cortex (anatomy)
mental disorders
medicine
Humans
In patient
cardiovascular diseases
Stage (cooking)
Aged
Advanced and Specialized Nursing
Intracerebral hemorrhage
cerebral hemorrhage
medicine.diagnostic_test
business.industry
nutritional and metabolic diseases
Calcinosis
Magnetic resonance imaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Pathophysiology
Cerebral Amyloid Angiopathy
medicine.anatomical_structure
Mutation
Female
Neurology (clinical)
Cerebral amyloid angiopathy
Occipital Lobe
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Calcification
Subjects
Details
- ISSN :
- 15244628
- Volume :
- 52
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....84564db5b470e50ea8353993a9838b34