London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 409 233 Brain imaging Are silent ischemic infarcts in cerebral amyloid angiopathy associated with subarachnoid hemorrhage ? C. JOIN-LAMBERT1, J. HODEL2, R. TAMAZYAN3, S. GERBER4, M. BRUANDET5, M. ZU-BER6 Stroke Center, Hôpital Saint-Joseph and Paris Descartes University, Paris, FRANCE1, Depart-ment of Radiology, Hôpital Saint-Joseph, Paris, FRANCE2, Stroke Center, Hôpital Saint-Joseph and Paris Descartes University, Paris, FRANCE3, Department of Radiology, Hôpital Saint-Joseph, Paris, FRANCE4, Stroke Center, Hôpital Saint-Joseph and Paris Descartes University, Paris, FRANCE5, Stroke Center, Hôpital Saint-Joseph and Paris Descartes University, Paris, FRANCE6 Background : Silent ischemic infarcts have been seldom reported in cerebral amyloid angiopathy (CCA) but little is known about prevalence and mechanisms. Whether these ischemic lesions could be associated with markers of CCA such as microbleeds and convexal subarachnoid hemorrhage (SAH) deserve some attention because of putative implications for prognosis and prevention. Methods : We performed a retrospective MRI analysis in 25 consecutive CCA patients. MRI was performed at time of CCA diagnosis. DWI sequences (optimized DWI in 13) were acutely inspected for infarcts and gradient-echo sequences (susceptibility-weighted angiography –SWAN- in 9) for all types of hemorrhages. Clinical data were also listed for all patients. Results : Silent ischemic infarcts were present in 14 (56%) of the patients, for a total of 32 ischemic spots (1 to 7 spots per patient, 7 patients with 1 spot). Two third of the spots were located in the cortex. Pa-tients with silent ischemic infarcts had no difference in age (79.1 y +/- 6.2), gender (64% female) or conventional vascular risk factors compared with those without. On the radiological point of view, small infarcts were not clearly associated with the presence of microbleeds, while convexal SAH was more frequently observed in patients with infarcts (11/14, 79%) than in those without (4/11, 36%, p=0.07). Among the 5 patients with 3 silent ischemic infarcts or more, SAH was observed in 4. Spots were close to convexal SAH in 4 cases. Conclusion : Pathologic studies suggest that cortical or subcortical microinfarctions are common in advanced CAA (37% to 100%). In this pilot study, prevalence of silent ischemic infarcts reached 56% and seemed to be associated with convexal SAH. Whether SAH could favour appearance of the isch-emic lesions in CCA patients remains to be settled. Optimized MRI could provide the opportunity to better visualize this type of lesions, leading to new insights into the cognitive prognosis of patients.
Karger_ESC London_2013
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