Clinical and neuropathologic analysis of intracerebral hemorrhage in patients with cerebral amyloid angiopathy

Yanagawa, Taro; Takao, Masaki; Yasuda, Masami; Kamide, Tomoya; Sato, Hiroki; Suzuki, Kaima; Ikeda, Toshiki; Kikkawa, Yuichiro; Kurita, Hiroki

doi:10.1016/j.clineuro.2018.11.020

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Hence, cerebrovascular insufficiency and vascular dementia co-exist with enhanced Aβ and senile plaques (Liu et al, 2015 ; Greenberg et al, 2020 ). Pathological amyloid accumulation also contributes to the development of subcortical intracerebral hemorrhage and hemorrhagic stroke in elderly AD patients (Vasilevko et al, 2010 ; Van Nostrand, 2016 ; Yanagawa et al, 2019 ). It distinctly connects with clinical conditions, such as intracranial bleeding, stroke, brain ischemia, ruptured aneurysm, head injury, and recurrent seizures.…”

Section: Current Theories For Admentioning

confidence: 99%

Role of Neuron and Glia in Alzheimer’s Disease and Associated Vascular Dysfunction

Bandyopadhyay

2021

Front. Aging Neurosci.

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Amyloidogenicity and vascular dysfunction are the key players in the pathogenesis of Alzheimer’s disease (AD), involving dysregulated cellular interactions. An intricate balance between neurons, astrocytes, microglia, oligodendrocytes and vascular cells sustains the normal neuronal circuits. Conversely, cerebrovascular diseases overlap neuropathologically with AD, and glial dyshomeostasis promotes AD-associated neurodegenerative cascade. While pathological hallmarks of AD primarily include amyloid-β (Aβ) plaques and neurofibrillary tangles, microvascular disorders, altered cerebral blood flow (CBF), and blood-brain barrier (BBB) permeability induce neuronal loss and synaptic atrophy. Accordingly, microglia-mediated inflammation and astrogliosis disrupt the homeostasis of the neuro-vascular unit and stimulate infiltration of circulating leukocytes into the brain. Large-scale genetic and epidemiological studies demonstrate a critical role of cellular crosstalk for altered immune response, metabolism, and vasculature in AD. The glia associated genetic risk factors include APOE, TREM2, CD33, PGRN, CR1, and NLRP3, which correlate with the deposition and altered phagocytosis of Aβ. Moreover, aging-dependent downregulation of astrocyte and microglial Aβ-degrading enzymes limits the neurotrophic and neurogenic role of glial cells and inhibits lysosomal degradation and clearance of Aβ. Microglial cells secrete IGF-1, and neurons show a reduced responsiveness to the neurotrophic IGF-1R/IRS-2/PI3K signaling pathway, generating amyloidogenic and vascular dyshomeostasis in AD. Glial signals connect to neural stem cells, and a shift in glial phenotype over the AD trajectory even affects adult neurogenesis and the neurovascular niche. Overall, the current review informs about the interaction of neuronal and glial cell types in AD pathogenesis and its critical association with cerebrovascular dysfunction.

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Section: Current Theories For Admentioning

confidence: 99%

Role of Neuron and Glia in Alzheimer’s Disease and Associated Vascular Dysfunction

Bandyopadhyay

2021

Front. Aging Neurosci.

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“…Furthermore, CAA has been reported to be associated with Alzheimer’s disease [ 3 , 4 ], as Aβ protein accumulation in the brain is thought to be involved in the development of both Alzheimer’s disease and CAA [ 5 ]. Because some patients with CAA develop cerebral subcortical hemorrhage, several studies on risk factors of cerebral subcortical hemorrhage other than Aβ accumulation have been conducted [ 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Association of antithrombotic therapy with postoperative rebleeding in patients with cerebral amyloid angiopathy

et al. 2023

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Background Cerebral amyloid angiopathy is a common cause of subcortical hemorrhage in older adults. Although open hematoma removal may be performed for severe subcortical hemorrhage, its safety in patients with cerebral amyloid angiopathy has not been established, and postoperative rebleeding may occur. Therefore, this study aimed to investigate factors associated with postoperative rebleeding. Methods Out of 145 consecutive patients who had undergone craniotomy for surgical removal of subcortical intracerebral hemorrhage between April 2010 and August 2019 at a single institution in Japan, we examined 109 patients with subcortical hemorrhage who met the inclusion criteria. After excluding 30 patients whose tissue samples were unsuitable for the study, the final study cohort comprised 79 patients. Results Of the 79 patients, 50 (63%) were diagnosed with cerebral amyloid angiopathy (cerebral amyloid angiopathy group) and 29 (37%) were not diagnosed with noncerebral amyloid angiopathy (noncerebral amyloid angiopathy group). Postoperative rebleeding occurred in 12 patients (24%) in the cerebral amyloid angiopathy group and in 2 patients (7%) in the noncerebral amyloid angiopathy group. Preoperative prothrombin time–international normalized ratio and intraoperative bleeding volume were significantly associated with postoperative rebleeding in the cerebral amyloid angiopathy group (odds ratio = 42.4, 95% confidence interval = 1.14–1578; p = 0.042 and odds ratio = 1.005, 95% confidence interval = 1.001–1.008; p = 0.007, respectively). Conclusions Patients with cerebral amyloid angiopathy-related cerebral hemorrhage who are receiving antithrombotic therapy, particularly warfarin therapy, are at a high risk of postoperative rebleeding. Trial registration Registry and Registration Number of the study: 19–220, 2019/12/23, retrospectively registered.

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“…In contrast with hypertensive intracerebral hemorrhages that typically develop in the deep sites of the cerebral and cerebellar hemispheres, those arising in the subcortical cerebrum are commonly known as subcortical hemorrhages. They typically develop in association with aging, dementia, and deposition of abnormal amyloid proteins in the cerebral arterioles [15 , 16] .…”

Section: Introductionmentioning

confidence: 99%

Simultaneous presentation of subcortical hemorrhage, subdural hemorrhage, and cerebral infarct in a hemiplegic patient

Sugiyama

Tsutsumi

Watanabe

et al. 2022

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Clinical and neuropathologic analysis of intracerebral hemorrhage in patients with cerebral amyloid angiopathy

Cited by 6 publications

References 21 publications

Role of Neuron and Glia in Alzheimer’s Disease and Associated Vascular Dysfunction

Role of Neuron and Glia in Alzheimer’s Disease and Associated Vascular Dysfunction

Association of antithrombotic therapy with postoperative rebleeding in patients with cerebral amyloid angiopathy

Simultaneous presentation of subcortical hemorrhage, subdural hemorrhage, and cerebral infarct in a hemiplegic patient

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