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Stroke:脑淀粉样血管病患者枕叶皮质钙化

2021-04-14 MedSci原创 MedSci原创

枕叶皮层钙化在D-CAA中很常见,但在散发性CAA中很少见。在症状前携带者中无钙化,并且与ICH无关,这可能表明它们是晚期CAA的标志。

据报道脑淀粉样血管病(CAA)患者伴有皮质钙化,尽管其患病率和病理生理机制尚未明确。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在调查计算机断层扫描影像结果上钙化的频率,以及钙化与脑出血(ICH)的关系,它们与枕叶皮纹共存的情况,这些表现反映了荷兰型遗传性CAA (D-CAA) 和散发性CAA在超高场7T磁共振成像的微钙化。

研究人员纳入了D-CAA突变携带者,这些携带者具有经证实的APP(淀粉样前体蛋白)突变或≥1脑叶ICH。D-CAA携带者伴有症状性ICH史时被认为是有症状患者。研究人员评估了受试者有无钙化,位置和进展及其与ICH和枕叶皮质的关系。

研究人员在15/81(19%[95%CI为11–29])D-CAA突变携带者中发现了皮质钙化(15/69有症状和0/12症状前)和1/59(2%[95%CI为0-9])散发性CAA患者。钙化均位于双侧枕叶。在有症状的D-CAA患者中,有3/15(20%)患者的钙化持续了10年。有证据表明皮质钙化与新发ICH相关(风险比为7.1 [95%CI为0.9-54.9],对数秩P=0.03)。在7/25例接受7T磁共振成像检查的D-CAA有症状携带者患者中,枕叶皮层呈条纹状,3/3(100%)例患者接受计算机断层扫描存在钙化,4/22(18%)患者则无钙化。

由此可见,枕叶皮层钙化在D-CAA中很常见,但在散发性CAA中很少见。在症状前携带者中无钙化,并且与ICH无关,这可能表明它们是晚期CAA的标志。计算机断层扫描上的皮质钙化似乎与7T磁共振成像上的枕叶条纹皮质有关,这可能代表了钙化的早期阶段。

原始出处:

Ingeborg Rasing.et al.Occipital Cortical Calcifications in Cerebral Amyloid Angiopathy.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033286

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    2021-04-14 七安

    三人行,必有我师。 #梅斯医学科研互助群# 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!

    0

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    2021-04-16 145f74eem60暂无昵称

    正好用上 学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2046678, encodeId=6eb320466e87b, content=<a href='/topic/show?id=9b708491280' target=_blank style='color:#2F92EE;'>#脑淀粉样#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84912, encryptionId=9b708491280, topicName=脑淀粉样)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dab8203, createdName=zsyan, createdTime=Sun Nov 28 07:21:56 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1644883, encodeId=32e0164488388, content=<a href='/topic/show?id=e3eb89e17fb' target=_blank style='color:#2F92EE;'>#血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89717, encryptionId=e3eb89e17fb, topicName=血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=64bb23195917, createdName=Luyuxie_17, createdTime=Tue Aug 10 05:21:56 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956820, encodeId=a0f49568206d, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/a7082efd72134f339011deffae56d660/9f9bdab2a00341ce92bf6fd196c67f81.png, createdBy=4e205474392, createdName=七安, createdTime=Wed Apr 14 10:03:41 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957494, encodeId=9d6f95e49403, content=正好用上 学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4505101983, createdName=145f74eem60暂无昵称, createdTime=Fri Apr 16 09:25:49 CST 2021, time=2021-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628781, encodeId=6f1e1628e81f5, content=<a href='/topic/show?id=1c748491616' target=_blank style='color:#2F92EE;'>#脑淀粉样血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84916, encryptionId=1c748491616, topicName=脑淀粉样血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Apr 15 23:21:56 CST 2021, time=2021-04-15, status=1, ipAttribution=)]

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JACC:房颤患者发生脑淀粉样血管病 管理策略出新招

2017年8月,发表在《J Am Coll Cardiol》的一项由美国科学家进行的研究,考察了房颤患者发生脑淀粉样血管病的诊断、临床意义和管理策略。

Lancet neurol:淀粉样脑血管病患者的皮质萎缩:病例对照研究

大脑皮层灰质缺失是很多神经退行性疾病的诊断标志,是认知功能障碍的重要介质。我们假定以皮质血管淀粉样蛋白沉积为特征的淀粉样脑血管病(CAA)与阿兹海默病的脑实质病变的病理不同,是皮质组织的缺失。我们在淀粉样变——荷兰型(HCHWA-D)遗传性脑出血患者中(一种单基因疾病伴随最小的或无阿兹海默病病理)、散发CAA患者中验证假说,以健康人群和阿兹海默病患者作为对照。

Stroke:脑凸面蛛网膜下腔出血对脑淀粉样血管病病情进展的影响

脑淀粉样血管病相关的皮质表面铁质沉着(cSS)可能提示后续脑内出血(ICH)的风险增加。我们希望确定与此相关联出血性事件的机制和顺序。研究方法:在9年的时间里,我们对明确患有自发性脑凸面蛛网膜下腔出血(cSAH) 的患者进行了进行了细致的临床和神经影像学数据的纵向分析。我们还对每一位患者进行了近距成像病理对照。研究结果:38位cSAH患者中(平均年龄,77±11岁),有29位(76%)患者在核磁共

Neurology:脑淀粉样血管病患者CSF生物标志物概况分析!

由此可见,Aβ42、Aβ40、t-tau和p-tau的特异性CSF模式可能是CAA的分子生物标志物,但需要在更大的CAA队列中进行分析。

Stroke:皮层表面铁质沉积者随访 MRI 的意义

皮层表面微血管淀粉沉积是脑淀粉样血管病(cerebral amyloid angiopathy,CAA),它是老年自发性脑叶出血的主要病因。

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