Calviere L, et al. - Researchers carried out this study to compare patients with cerebral amyloid angiopathy (CAA) vs non-CAA-related convexal subarachnoid haemorrhage (cSAH). In having transient focal neurological episodes (TFNE) as a frequent clinical presentation, a high prevalence of cortical superficial siderosis (cSS) and an increased risk of recurrent subarachnoid bleeding, CAA differed from other cSAH. However, the evolution from acute cSAH to focal cSS could not be specific to CAA.

Methods

• The researchers performed a retrospective review of baseline and follow-up data of consecutive patients admitted with a symptomatic acute cSAH.

Results

• The researchers included 62 patients (mean age 66.2 ± 14.1 years), of whom 31 with probable CAA.
• CAA patients presented more frequently with transient symptoms (83.9 vs 19.3%; p < 0.001) usually without headache (19.0 vs 58.1%; p=0.002).
• They observed these essentially positive sensory disturbance in CAA that met the criteria of TFNE.
• Factors more often associated with CAA were cortical superficial siderosis (cSS) (80.6 vs 0%; p < 0.001) and lobar cerebral microbleeds (83.4 vs 9%; p < 0.001).
• Recurrent symptomatic cSAH occurred in 4/27 (12.9%) CAA patients and in 0/27 non-CAA patients, during a mean of 22 months of follow-up.
• cSAH recurrences were observed in 44% of CAA patients vs 13.3% of other cases (p=0.08) and extension of cSS was detected only in CAA (60%) (p < 0.001), among 40 patients with MRI follow-up.
• In this study, acute cSAH evolved to cSS in 96% and 73.3% of CAA and non-CAA patients, respectively (p=0.06).