Cerebral amyloid angiopathy: detection, diagnosis, and hemorrhage prediction

Abstract

The overall aim of the studies described in this thesis was to improve cerebral amyloid angiopathy (CAA) detection and diagnosis, and to make predictions about intracerebral hemorrhage.

The first part of this thesis investigates methods to detect CAA pathology more directly in both an early and later phase by 1) measuring levels of Amyloid-ß in the cerebrospinal fluid, 2) measuring the thickness of the retinal nerve fiber layer with spectral domain optical coherence tomography, 3) looking for new markers in 7-Tesla MRI, and 4) testing the Edinburgh CT criteria for CAA-related lobar intracerebral hemorrhage in D-CAA mutation carriers. In the second part of this thesis, trigger factors for spontaneous intracerebral hemorrhage are studied with a case-crossover design, prognosis of patients with isolated microbleeds is compared with patients presenting with lobar ICH, the association between small vessel disease markers and the extent of bleeding in the acute phase is studied, and the disease course of D-CAA mutation carriers and patients with sporadic CAA after a lobar intracerebral hemorrhage is described.