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Transient focal neurological episode (TFNE) is the most frequent presenting symptom of convexity subarachnoid haemorrhage (cSAH) in elderly patients with non-traumatic cSAH with suspected, possible or probable cerebral amyloid angiopathy (CAA). The aim of our study was to analyse in detail clinical and MRI characteristics in these patients.
Methods: We performed a retrospective study analysing baseline, acute clinical symptom (TFNE and headache), and MRI characteristics (acute cSAH and chronic CAA features) of consecutive elderly (≥55 years) patients, recruited and registered in the stroke database, between june 2008 and october 2020 of two centres (Nîmes and Montpellier University Hospital, France), presenting with cSAH with suspected, possible, or probable CAA.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients | Consecutive elderly (≥55 years) patients, recruited and registered in the stroke database of two centres (Nîmes University Hospital and Montpellier University Hospital, France), presenting with cSAH with suspected, possible, or probable CAA. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| usual care | Other | according to recommendations |
|
| Measure | Description | Time Frame |
|---|---|---|
| Description of MRI | Extent of acute cSAH (number of sulci, focal [≤3 sulci] or diffuse [>3 sulci], surface) | day of the diagnosis |
| Description of MRI | the multifocality of acute cSAH (as described for cortical superficial siderosis (CSS)), sulci involved by cSAH, CSS presence, CSS extent (focal, ≤3 sulci; diffuse >3 sulci) | day of the diagnosis |
| Description of MRI | cerebral microbleeds (CMB, <10 mm) presence | day of the diagnosis |
| Description of MRI | cerebral microbleeds number | day of the diagnosis |
| Description of MRI | cerebral microbleeds categorisation (according to the Microbleed Anatomical Rating Scale), | day of the diagnosis |
| Description of MRI | presence and number of chronic lobar intracerebral haemorrhage (ICH) (>10 mm) | day of the diagnosis |
| Description of MRI | Extent of white matter hyperintensities (periventricular Fazekas scale 0-3) | day of the diagnosis |
| Clinical parameters | Transient focal neurological episode (TFNE) presence |
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Inclusion Criteria:
Exclusion Criteria:
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consecutive elderly (≥55 years) patients, recruited and registered in the stroke database of two centres (Nîmes University Hospital and Montpellier University Hospital, France), presenting with cSAH with suspected, possible, or probable CAA.
The patients were classified as possible or probable CAA according to the modified Boston criteria. Since cortical superficial siderosis (CSS), incorporated in the modified Boston criteria, is probable a result of an earlier acute cSAH, we considered patients with acute cSAH in the absence of other typical CAA-related haemorragic features as patients with suspected CAA.
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| Name | Affiliation | Role |
|---|---|---|
| Anissa MEGZARI | Centre Hospitalier Universitaire de Nīmes | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nîmes | Nîmes | 30029 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36241843 | Derived | Autieri V, Gaillard N, Mourand I, Laurent-Chabalier S, Mura T, Trandafir C, Wacongne A, de Champfleur NM, Thouvenot E, Pereira F, Renard D. Primary acute convexity subarachnoid hemorrhage in older patients: analysis of baseline, clinical and MRI characteristics including quantitative surface study and topographical probabilistic mapping of convexity subarachnoid hemorrhage. Acta Neurol Belg. 2023 Apr;123(2):519-527. doi: 10.1007/s13760-022-02115-8. Epub 2022 Oct 14. |
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| ID | Term |
|---|---|
| D016657 | Cerebral Amyloid Angiopathy |
| D013345 | Subarachnoid Hemorrhage |
| ID | Term |
|---|---|
| D002539 | Cerebral Arterial Diseases |
| D020765 | Intracranial Arterial Diseases |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
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| day of the diagnosis |
| Clinical parameters | number of TFNE preceding MRI | day of the diagnosis |
| Clinical parameters | TFNE symptoms (sensory, motor, visual, speech; positive or negative symptoms | day of the diagnosis |
| Clinical parameters | Presence and speed of spreading TFNE symptoms | day of the diagnosis |
| Clinical parameters | Correlation of TFNE symptoms to cSAH localisation | day of the diagnosis |
| Clinical parameters | headache (Yes/No) | day of the diagnosis |
| Clinical parameters | antiepileptic drugs (AED) introduction and type of AED introduced | day of the diagnosis |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D000686 | Amyloidosis |
| D057165 | Proteostasis Deficiencies |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D020300 | Intracranial Hemorrhages |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |