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(Stroke. 2008;39:2699.)
© 2008 American Heart Association, Inc.

Editorials

Cerebral Amyloid Angiopathy, Hemorrhages and Superficial Siderosis

Irina Alafuzoff, MD, PhD

From the Department of Clinical Medicine, Unit of Neurology, Section of Neuropathology, Kuopio University, Kuopio, Finland; and the Department of Pathology, Kuopio University Hospital, Kuopio, Finland.

Correspondence to Irina Alafuzoff, MD, PhD, Kuopio University, PO Box 1647, Harjulantie 1, Kuopio, Finland 70211. E-mail irina.alafuzoff@uku.fi

Key Words: amyloid angiography • imaging

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2894–2897.

In this issue of Stroke, Feldman and coworkers¹ describe 3 subjects with clinically somewhat atypical Alzheimer Disease (AD) and with a radiologically verified superficial siderosis (SS). In 2 of these patients, a neuropathological examination confirmed AD with concomitant cerebral amyloid angiopathy (CAA) and a premortem diagnosis of SS. Thus, a linkage was made between CAA, SS and atypical AD. This report highlights 3 issues of major interest. First, are chronic hemorrhages due to CAA and SS factors to be taken into account when dealing with subjects with AD or vascular cognitive impairment (VCI) due to CAA. Secondly, should we consider conducting imaging analysis in demented subjects displaying a somewhat atypical clinical phenotype of AD and/or VCI. Finally, can gradient-recalled echo (GRE) T2*-weighted MRI be exploited as a tool to identify those individuals with severe CAA?

Superficial siderosis is defined as a condition where hemosiderin is deposited in the subpial layer of the central nervous system with the symptoms developing after chronic repeated subarachnoidal hemorrhages (SAH). Already in 1960, Iwanowski and Olszewski were able to experimentally reproduce SS in dogs by repeated subarachnoidal injections of blood.² In the review article from 1995 by Fearnly and colleagues, one can find a comprehensive summary of the issues regarding clinical, radiological and pathological findings observed in this entity.³ In a more recent case report including a fine review of the literature, Levy and colleagues summarized the findings of the worldwide published reports (ie, 270 SS cases) and . . . [Full Text of this Article]

Related Article:

Superficial Siderosis: A Potential Diagnostic Marker of Cerebral Amyloid Angiopathy in Alzheimer Disease

Howard H. Feldman, Luis F. Maia, Ian R.A. Mackenzie, Bruce B. Forster, Jeff Martzke, and Andrew Woolfenden
Stroke 2008 39: 2894-2897. [Abstract] [Full Text] [PDF]

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				M. W. Vernooij, M. A. Ikram, A. Hofman, G. P. Krestin, M.M.B. Breteler, and A. van der Lugt Superficial siderosis in the general population Neurology, July 21, 2009; 73(3): 202 - 205. [Abstract] [Full Text] [PDF]