Abstract
BackgroundCerebral Amyloid Angiopathy has been indicated as an important cause of spontaneous non-hypertensive intracerebral haemorrhage (ICH).Aimsto analyze the presence of β-amyloid deposit in the temporal artery of consecutive patients with ICH in comparison to control subjects and its relation to APO-E haplotype frequency.MethodsWe enrolled consecutive patients admitted to Neurosurgery Ward of University Hospital “P. Giaccone” of Palermo with a diagnosis of spontaneous non hypertensive ICH and as control 12 subjects without brain haemorrhage. Biopsy of superficial temporal artery has been performed and β-amyloid deposit was quantified.ResultsAmong 25 subjects with ICH, 10 (40%) had APOE epsilon 2 allele and among these subjects 7 (70%) showed amyloid accumulation on temporal artery specimens, 8 (32%) subjects had APOE epsilon 3 allele and among these subjects only 2 (25%) showed amyloid accumulation on temporal artery specimens, whereas 7 (28%) had APOE epsilon 4 allele and of these, 7 (100%) showed amyloid accumulation on temporal artery specimens. At multivariable logistic regression analysis for the presence of amyloid, predictive factors for the presence of amyloid in temporal artery biopsies were: age, hypertension, intralobar site of haemorrhage, APOE epsilon 2 and APOE epsilon 4 alleles.DiscussionOur findings of a higher frequency of amyloid deposition in temporal artery specimens in subjects with spontaneous intracerebral haemorrhage indicate a possible role of temporal artery as a possible diagnostic site of biopsy in subjects at high risk to develop intracranial haemorrhage related to Cerebral Amyloid Angiopathy.
Highlights
Spontaneous non-traumatic intracerebral haemorrhage (ICH) is the second most prevalent subtype of stroke, and it has been associated with high mortality and morbidity throughout the world [1, 2]
Subjects with ICH in comparison with controls showed a higher severity of amyloid accumulation either according the Vonsattel scale (2.6 ± 0.9 vs 1.1 ± 0.8) and a higher percentage of β-amyloid deposit measured by Mountjoy scale (3.56 ± 1.1 vs 1.38 ± 0.7)
We report that in subjects with spontaneous intracerebral haemorrhage, histological analysis of temporal artery specimens show an accumulation of β-amyloid
Summary
Spontaneous non-traumatic intracerebral haemorrhage (ICH) is the second most prevalent subtype of stroke, and it has been associated with high mortality and morbidity throughout the world [1, 2]. It usually results from the rupture of small arteries in the brain and represents 10–30% of all strokes [3]. Cerebral Amyloid Angiopathy (CAA) has been rediscovered as a common cause of spontaneous ICH [4, 5]. Cerebral Amyloid Angiopathy has been indicated as an important cause of spontaneous non-hypertensive intracerebral haemorrhage (ICH)
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