AUTHOR=Wagner Andrea , Maderer Jonas , Wilfling Sibylle , Kaiser Johanna , Kilic Mustafa , Linker Ralf A. , Schebesch Karl-Michael , Schlachetzki Felix 

TITLE=Cerebrovascular Risk Factors in Possible or Probable Cerebral Amyloid Angiopathy, Modifier or Bystander?

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.676931

DOI=10.3389/fneur.2021.676931

ISSN=1664-2295

ABSTRACT=Goal: Cerebral amyloid angiopathy (CAA) is a frequent cause of atypical intracerebral hemorrhage (ICH) in the elderly. Stroke risk factors such as arterial hypertension (aHT), atrial fibrillation (aFib), diabetes mellitus (DM), and renal dysfunction (rD) are increasingly apparent in these patients. In this retrospective study, we analyzed the presence of these stroke risk factors in different initial CAA presentations comprising cerebral microbleeds (cMB), acute ischemic stroke (AIS), cortical superficial hemosiderosis (cSS) or lobar ICH (lICH) and evaluated their influence on initial clinical presentation of CAA patients. 
Material and methods: We identified patients with “at least” possible CAA defined by the modified Boston criteria admitted to the Department of Neurology or Neurosurgery from 2002 to 2018.  
Findings: In the overall cohort of 209 patients, we analyzed the correlation between the number of stroke risk factors and the initial clinical presentation of patients with CAA and could show the high multimorbidity of our collective. There are large differences between the subgroups with different initial clinical presentation, e.g., patients with cMB as initial CAA presentation have the highest number of cerebrovascular risk factors and of recurrent AIS, whereas atrial fibrillation is more frequent in Neurosurgery Department.
Conclusion: There is a distinct overlap between the subgroups of CAA manifestations and stroke risk factors that need to be verified in larger patient collectives. Since these comorbidities are likely to influence the clinical course of CAA, they represent possible targets for secondary prevention until specific treatment for CAA becomes available.