ArticleScientific reports2025
Pathological findings from surgical specimens and long-term outcome in cerebral amyloid angiopathy patients with intracerebral hemorrhage.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Between a Rock and a Hard Place: Balancing Embolic Stroke and Intracerebral Hemorrhage Risk in Left Atrial Appendage Occlusion.Journal of cardiovascular development and disease · 2026Review
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11 authors.
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Abstract
Sporadic cerebral amyloid angiopathy (CAA) is a small-vessel disease. We sought to assess pathological findings and outcomes in CAA patients with non-traumatic intracerebral lobe hemorrhage (ICH). Sixty-three CAA-ICH patients underwent Hematoxylin-eosin, amyloid-β, smooth muscle actin, and CD34 staining. Arterioles were graded using a CAA-severity scale. Prospective ≥ 12-month follow-up identified prognostic factors via Spearman correlation analysis and binary logistic regression. Cox proportional hazard regression models assessed mortality or recurrent ICH risk associations. Among 93 Chinese ICH patients, 63 (67.7%) were diagnosed with CAA. Pathological grading showed Grade 1: 8 (12.7%), Grade 2: 12 (19.0%), Grade 3-4: 43 (68.3%). The median preoperative hematoma volumes in patients with Grade 1, Grade 2, and Grades 3-4 CAA were 42 mL (30-53), 50 mL (41-60), and 55 mL (48-89), respectively (p = 0.016). Among 32 CAA patients with available cortical specimens, 23 (71.9%) exhibited dense-core plaques and 26 (81.3%) showed diffuse plaques. Dense-core plaques were observed predominantly in moderate-to-severe (Grades 2-4) CAA. Cortical superficial siderosis (cSS) moderately correlated with CAA severity (R = 0.528, p = 0.006). After adjusting for age, sex, antiplatelet therapy, and alcohol abuse, CAA severity predicted 1-year mortality (adjusted odds ratio [OR] = 18.49; 95% confidence interval [CI], 1.78-193.03; p = 0.015). Both CAA severity and age predicted mortality or recurrent ICH risk (adjusted hazard ratio [HR] = 4.16; 95% CI, 1.54-11.24; p = 0.005; and adjusted HR = 1.08; 95% CI, 1.02-1.14; p = 0.008, respectively). CAA severity also independently predicted the risk of recurrent ICH (adjusted HR = 5.65; 95% CI, 1.25-25.62; p = 0.025). Most CAA-ICH patients had moderate-to-severe CAA in cortico-leptomeningeal regions. Cortical biopsies revealed frequent amyloid-β (Aβ) deposition in dense-core and diffuse plaques, with dense-core plaques predominating in moderate-to-severe CAA. CAA severity correlated with long-term outcomes in CAA-ICH.
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