Neurology: Among patients with cerebral amyloid vascular disease, those with lacunar infarction are more likely to have cerebral hemorrhage

Sporadic cerebral amyloid vascular disease (Sporadic cerebral amyloid angiopathy, CAA) is common in the elderly small vessel disease, pathology characterized by β-amyloid accumulation in the cortex and soft retinal blood vessels.

CAA can cause ischemic lesions such as intralobular hemorrhage (ICH), lobar microhemorrhage (CMBs), white matter hyperintensity lesions (WMH), cortical cerebral microinfarction (CMIs) and other ischemic lesions.

Recent studies have shown that compared with patients with hypertensive deep ICH (HTNICH), lacune located in the lobe region is more common in patients with CAA-related ICH.

In this way, Elif Gokcal of Harvard University and others explored the relationship between lacunar infarction and cortical cerebral microinfarctions (CMIs), assessed its relationship with vascular dysfunction, and studied its effect on cerebral amyloid angiopathy (CAA) in intracerebral hemorrhage (ICH) The impact of risk.

In this study, they hypothesized that lacune and CMIs have similar mechanisms, so patients with CAA and lacune are more likely to have CMIs.

In addition, vascular dysfunction is the main contributor to global cerebral ischemia in CAA, but has nothing to do with the formation of lacune and CMI, and it is believed that this is mainly due to focal vascular disease.

Finally, the potential impact of the presence of lacunar infarction on the risk of ICH events in CAA patients was discussed.

They used a prospectively registered CAA cohort to retrospectively analyzed the number and topography of lacunar infarcts (deep/lobes), CMIs, and WMH volumes.

They included 122 probable CAA patients (mean age 69.

Compared with patients without lacunar infarction, cortical CMIs were more common in patients with fissures (51.

In univariate and multivariate Cox regression models, lacunar infarction was associated with an increased risk of ICH (p = 0.

The important significance of this study in CAA is to find that the incidence of cerebral lobular infarction in CAA is very high, and it often coexists with CMIs, suggesting that these two types of lesions may be part of the common lineage of CAA-related infarctions.