Alzheimer Dementia- Cerebral Amyloid Vascular Disease, an authoritative meta-analysis

Cerebral amyloid vascular disease (CAA) is the accumulation of amyloid, the most common are amyloid β (Aβ) accumulate in the walls of cerebral blood vessels, leading to weakened blood vessels, resulting in the risk of major intracerebral hemorrhage (ICH) is
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Patients with CAA may have a wide range of clinical symptoms, including cognitive decline, lobe ICH, and transient focal neurological attacks (recurring, stereotyped, short and smoothly spreading secondary sensations, numbness or weakness attacks, usually continuous A few seconds to a few minutes, usually relieved in a similar period)
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A rare complication of the disease is inflammation associated with CAA, which is characterized by headaches,Seizures , behavioral changes, focal nervous system signs, disturbances in consciousness, and accompanied by asymmetric high-intensity T2-weighted magnetic resonance imaging (MRI) lesions, can be treated with immunotherapy

A definite diagnosis of CAA can only be obtained through postmortem neuropathological evaluation of brain tissue
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Aβ in blood vessels can be stained with thioflavin or Congo red, or immunohistochemically observed with antibodies against Aβ

These Boston standards are based on two imaging markers related to CAA: Strictly speaking, lobar microhemorrhage (limited to cerebellar hemorrhage in the cerebral cortex and subcortical area), and superficial cortical rust (blood breakdown products in the brain) Deposition in the cortical groove of the convex surface of the hemisphere)
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Recently, positron emission tomography amyloid tracer has been successfully developed, but because the tracer is not specific for amyloid deposition in blood vessels, and it is difficult to distinguish it from the substantial amyloid deposition in AD , So its diagnostic role is still limited

In this way, the Netherlands Ladebaode University of Anna M.
De Kort and others, the system meta-analysis of the current literature CAA, and the corresponding clinical features, diagnosis and treatment to make a summary
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In a meta-analysis of 170 studies including more than 73,000 subjects, they found that in AD patients, the prevalence of CAA based on pathology (48%) is based on the strict sense of cerebral lobe microhemorrhage ( 22%); in the general population, the difference is three times (23% vs 7%)
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Both methods produced similar estimated prevalence of CAA in elderly people with normal cognition (5% to 7%), patients with intracerebral hemorrhage (19% to 24%), and patients with intralobular hemorrhage (50% to 57%)
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However, they observed a large heterogeneity between neuropathology and MRI protocols, which requires standardized assessment and reporting of CAA
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