ArticleAnnals of neurology2019
Different microvascular alterations underlie microbleeds and microinfarcts.
Article in Annals of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Pathological Changes of Small Vessel Disease in Intracerebral Hemorrhage: a Systematic Review and Meta-analysis.Translational stroke research · 2024Pooled it
- Association of Intensive vs Standard Blood Pressure Control With Regional Changes in Cerebral Small Vessel Disease Biomarkers: Post Hoc Secondary Analysis of the SPRINT MIND Randomized Clinical Trial.JAMA network open · 2023Trial
- Clustering of Cerebral Microbleeds in Cerebral Amyloid Angiopathy: A Flow Territory-Based Analysis.Journal of magnetic resonance imaging : JMRI · 2026Article
- Following the curvature: Sulcal versus gyral cortical localization of cerebral microbleeds in cerebral amyloid angiopathy.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Article
- White Matter and Perivascular Imaging Changes in Alzheimer's Disease and Cerebral Amyloid Angiopathy.Annals of clinical and translational neurology · 2026Article
- Cerebral small vessel disease: pearls and pitfalls from unexplored risk factors to treatment.Arquivos de neuro-psiquiatria · 2026Review
- Spatiotemporal Associations Between Cortical Microinfarcts and Cortical Superficial Siderosis in Cerebral Amyloid Angiopathy.Neurology · 2026Article
- Incidental DWI-Positive Lesions in 2 Cohorts of CAA and CADASIL: Prevalence, Distribution, and Associations With Clinical Variables.Neurology · 2026Article
- Long-Term Blood Pressure Variability in Cerebral Amyloid Angiopathy is Associated with Ischemic Brain Injury and Cognitive Decline.Journal of the American Heart Association · 2026Observational
- Contrasting patterns of leptomeningeal and parenchymal gadolinium extravasation in cerebral amyloid angiopathy: An MRI-based evaluation.International journal of stroke : official journal of the International Stroke Society · 2026Article
- Review
- Review
- Cortical Cerebral Microinfarcts in Spontaneous Intracerebral Hemorrhage on 3T and 7T MRI.Neurology · 2025Observational
- Relationship between cerebral small vessel disease and proteinopathies in the medial temporal lobe.Acta neuropathologica communications · 2025Article
- Review
- Cerebrospinal Fluid Beta-Amyloid Concentration and Clinical and Radiographic Manifestations of Cerebral Amyloid Angiopathy.Journal of the American Heart Association · 2025Article
- Location and Timing of Recurrent, Nontraumatic Intracerebral Hemorrhage.JAMA neurology · 2025Article
- Cerebral Amyloid Angiopathy: Clinical Presentation, Sequelae and Neuroimaging Features-An Update.Biomedicines · 2025Review
- Neurovascular Decoupling Is Associated With Lobar Intracerebral Hemorrhages and White Matter Hyperintensities.Journal of the American Heart Association · 2025Observational
- Distinct neuroinflammatory patterns between cerebral microbleeds and microinfarcts in cerebral amyloid angiopathy.Annals of clinical and translational neurology · 2024Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveCerebral amyloid angiopathy (CAA) is characterized by the accumulation of amyloid β (Aβ) in the walls of cortical vessels and the accrual of microbleeds and microinfarcts over time. The relationship between CAA severity and microbleeds and microinfarcts as well as the sequence of events that lead to lesion formation remain poorly understood.
methodsWe scanned intact formalin-fixed hemispheres of 12 CAA cases with magnetic resonance imaging (MRI), followed by histopathological examination in predefined areas and serial sectioning in targeted areas with multiple lesions.
resultsIn total, 1,168 cortical microbleeds and 472 cortical microinfarcts were observed on ex vivo MRI. Increasing CAA severity at the whole-brain or regional level was not associated with the number of microbleeds or microinfarcts. However, locally, the density of Aβ-positive cortical vessels was lower surrounding a microbleed compared to a simulated control lesion, and higher surrounding microinfarcts. Serial sectioning revealed that for (n = 28) microbleeds, both Aβ (4%) and smooth muscle cells (4%) were almost never present in the vessel wall at the site of bleeding, but Aβ was frequently observed upstream or downstream (71%), as was extensive fibrin(ogen) buildup (87%). In contrast, for (n = 22) microinfarcts, vascular Aβ was almost always observed at the core of the lesion (91%, p < 0.001) as well as upstream or downstream (82%), but few vessels associated with microinfarcts had intact smooth muscle cells (9%).
interpretationThese observations provide a model for how a single neuropathologic process such as CAA may result in hemorrhagic or ischemic brain lesions potentially through 2 different mechanistic pathways. ANN NEUROL 2019;86:279-292.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.