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The diagnosis of intracerebral hemorrhage (ICH) is a critical step for both acute and long-term treatment .
Hypertensive cerebral small vessel disease is the most common etiological diagnosis, however, in lobar intracerebral hemorrhage, evaluating the etiology of bleeding is a more challenging task .
For the latter, a common diagnosis represents sporadic cerebral amyloid angiopathy (CAA) , which at least doubles the risk of recurrent attacks .
Therefore, decisions regarding long-term management , especially for patients requiring antithrombotic prophylaxis , are often challenging .
In addition, secondary causes, such as arteriovenous malformations, cavernous hemangiomas, aneurysms, or tumors, may require more specific acute treatment strategies .
Hypertensive cerebral small vessel disease is the most common etiological diagnosis, however, in lobar intracerebral hemorrhage, evaluating the etiology of bleeding is a more challenging task .
For the latter, a common diagnosis represents sporadic cerebral amyloid angiopathy (CAA) , which at least doubles the risk of recurrent attacks .
Therefore, decisions regarding long-term management , especially for patients requiring antithrombotic prophylaxis , are often challenging .
In addition, secondary causes, such as arteriovenous malformations, cavernous hemangiomas, aneurysms, or tumors, may require more specific acute treatment strategies .
Intracerebral hemorrhage (ICH) diagnosis of hypertensive vascular sporadic cerebral amyloid angiopathy (CAA) management of thromboprophylaxis
The current standard for the in vivo diagnosis of CAA represents MRI with blood-sensitive sequences for the detection of cerebral microbleeds and superficial cortical siderosis (assessed by modified Boston criteria)
.
The current standard for the in vivo diagnosis of CAA represents MRI with blood-sensitive sequences for the detection of cerebral microbleeds and superficial cortical siderosis (assessed by modified Boston criteria)
.
We investigated the accuracy and clinical utility of the simplified Edinburgh CT criteria in identifying underlying cerebral amyloid angiopathy (CAA)
This external validation analysis was derived from a prospective single-center observational cohort study (2006-2015, UKER-ICH, NCT03183167)
.
This external validation analysis was derived from a prospective single-center observational cohort study (2006-2015, UKER-ICH, NCT03183167)
- According to the simplified Edinburgh CT criteria, 70 cases (33.
3%) were high-risk, 67 (31.
9%) were intermediate-risk, and 73 (34.
8%) were low-risk, showing moderate score differences
.
The application of the simplified Edinburgh CT criteria appears to be clinically useful in the diagnostic effort to accurately identify lobar intracerebral hemorrhage in patients with CAA
This study provides class II evidence that, in patients with major bleeding, the simplified Edinburgh criteria accurately identified those at high risk of CAA
Source:Sembill JA, Knott M, Xu M, et al.
Simplified Edinburgh CT Criteria for Identification of Lobar Intracerebral Hemorrhage Associated With Cerebral Amyloid Angiopathy [published online ahead of print, 2022 Mar 21].
Sembill JA, Knott M, Xu M, et al.
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