EVALUATION OF THE UNITED KINGDOM NATIONAL EXTERNAL QUALITY ASSESSMENT SERVICE 2008 (UK NEQAS 2008) GUIDELINES FOR THE DIAGNOSIS OF SUBARACHNOID HEMORRHAGE USING SPECTROPHOTOMETRIC XANTHOCHROMIA: A RETROSPECTIVE STUDY

2009 ◽  
Vol 32 (6S) ◽  
pp. 5
Author(s):  
A Gangloff ◽  
L Nadeau
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Viral Encephalitis ◽  
Objective Evaluation ◽  
Final Diagnosis ◽  
Amyloid Angiopathy ◽  
The United Kingdom ◽  
Cerebral Amyloid ◽  
The One ◽  
The Uk

Objective: Evaluation of the UK NEQAS 2008 guidelines for the interpretation of spectrophotometric xanthochromia. Method: A search of the laboratory database for all the xanthochromia test results between May 1st 2008 and May 1st 2009 was performed. Medical charts were reviewed for patients of Hôpital de l’Enfant-Jésus (HEJ) that had at least one detectable pigment (bilirubin, oxyhemoglobin, or methemoglobin). Xanthochromia results obtained with 4 different criteria (Chalmers original, Modified Chalmers, Duiser and UK NEQAS 2008) were compared. Results: We reviewed 41 medical charts (2 patients with duplicate lumbar punctures (LP) for a total of 43 LP). For these 41 patients there were 11 positive xanthochromia results, 5 of which were in concordance with a final diagnosis of subarachnoid hemorrhage (SAH). The diagnosis of the 6 other positive xanthochromia results were as follow: meningeal spread of a lymphoma, cerebral amyloid angiopathy, exertional headache, viral encephalitis with a possibility of petechiaes on the cerebral CT and second LP. Interpretation (negative/positive) of 40/43 LP was identical for the 4 methods. 2 LP were positive with Duiser and UK NEQAS 2008 but negative with Chalmers approaches (final diagnosis: SAH and cerebral amyloid angiopathy). 1 LP was positive only by the Duiser method (viral encephalitis). Conclusions: UK NEQAS 2008 guidelines identified all SAH but are sensitive to traumatic and pathologic meningeal lesions. Except for a case of viral encephalitis with a suspicion of cerebral petechiaes on CT, UK NEQAS 2008 gave xanthochromia results similar to the one in use at HEJ (Duiser). Chalmers original and Modified Chalmers methods missed one of the five SAH.

scholarly journals Recurrent craniospinal subarachnoid hemorrhage in cerebral amyloid angiopathy

2013 ◽  
Vol 16 (1) ◽  
pp. 97 ◽  
Author(s):  
Mathew Alexander ◽  
Anil KumarB Patil ◽  
Vivek Mathew ◽  
Ajith Sivadasan ◽  
Geeta Chacko ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Cerebral Amyloid

scholarly journals Risk of Intracerebral Hemorrhage and Mortality After Convexity Subarachnoid Hemorrhage in Cerebral Amyloid Angiopathy

Stroke ◽  
2019 ◽  
Vol 50 (9) ◽  
pp. 2562-2564 ◽  
Author(s):  
Lionel Calviere ◽  
Alain Viguier ◽  
Sofia Patsoura ◽  
Vanessa Rousseau ◽  
Jean-François Albucher ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Cerebral Amyloid

scholarly journals Cerebral Amyloid Angiopathy with Cortical Subarachnoid Hemorrhage as a Mimic for Transient Ischemic Attack: A Case Report

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Mazyar Hashemilar ◽  
Nasrin Forghani
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Clinical Findings ◽  
Amyloid Angiopathy ◽  
Cortical Region ◽  
Transient Ischemic Attacks ◽  
Life Threatening ◽  
Cerebral Amyloid ◽  
Ischemic Attack ◽  
Frontal Cortical Region

Context: Given its cerebral amyloid angiopathy, subarachnoid hemorrhage might represent transient focal neurological episodes erroneously diagnosed as transient ischemic attacks. The earliest neuroimaging findings in emergency room brain computed tomography indicating subarachnoid hemorrhage in these patients might be very subtle and missed by the clinician. Case Presentation: An 80-year-old man referred with transient focal neurological episodes, suggestive of transient ischemic attacks. In general, except for some cognitive dysfunctions, no remarkable point was noticed in his neurological examination. Non-enhanced brain-computer tomography and magnetic resonance imaging revealed evidence indicating slight convexity subarachnoid hemorrhage at the left frontal cortical region. Conclusions: The transient focal neurological episodes uncommonly represent intracranial hemorrhage. Nevertheless, this clinical representation might occur in patients with subarachnoid hemorrhage due to cerebral amyloid angiopathy. In such cases, the neuroimaging findings play a major role in the differential diagnosis. The misdiagnosis of transient ischemic attacks in these cases might lead to the consumption of antiplatelet drugs and end in catastrophic hemorrhage and life-threatening complications. Close attention to patients' clinical findings and judicious use of further neuroimaging studies would help clinicians to avoid making such mistakes.

scholarly journals The Characteristics of Superficial Siderosis and Convexity Subarachnoid Hemorrhage and Clinical Relevance in Suspected Cerebral Amyloid Angiopathy

2015 ◽  
Vol 39 (5-6) ◽  
pp. 278-286 ◽  
Author(s):  
Jun Ni ◽  
Eitan Auriel ◽  
Jenelle Jindal ◽  
Alison Ayres ◽  
Kristin M. Schwab ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracerebral Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Epileptiform Activity ◽  
Brain Mri ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Cerebral Bleeding ◽  
Cerebral Amyloid

Background and Aims: Systematic studies of superficial siderosis (SS) and convexity subarachnoid hemorrhage (cSAH) in patients with suspected cerebral amyloid angiopathy (CAA) without lobar intracerebral hemorrhage (ICH) are lacking. We sought to determine the potential anatomic correlation between SS/cSAH and transient focal neurological episodes (TFNE) and whether SS/cSAH is predictor of future cerebral hemorrhagic events in these patients. Methods: We enrolled 90 consecutive patients with suspected CAA (due to the presence of strictly lobar microbleeds (CMBs) and/or SS/cSAH) but without the history of symptomatic lobar ICH who underwent brain MRI including T2*-weighted, diffusion-weighted imaging and fluid-attenuated inversion recovery sequences from an ongoing single center CAA cohort from 1998 to 2012. Evaluation of SS, cSAH and CMBs was performed. Medical records and follow-up information were obtained from prospective databases and medical charts. TFNE was defined according to published criteria and electroencephalogram reports were reviewed. Results: Forty-one patients (46%) presented with SS and/or cSAH. The prevalence of TFNE was significantly higher in those with SS/cSAH (61 vs. 10%; p < 0.001) and anatomically correlated with the location of cSAH, but not SS. The majority of TFNE in patients with SS/cSAH presented with spreading sensory symptoms. Intermittent focal slowing on electroencephalogram was present in the same area as SS/cSAH in 6 patients, but no epileptiform activity was found in any patients. Among those with available clinical follow-up (76/90 patients, 84%), ten patients with SS/cSAH (29%, median time from the scan for all patients with SS/cSAH: 21 months) had a symptomatic cerebral bleeding event on follow up (average time to events: 34 months) compared with only 1 event (2.4%, 25 months from the scan) in patients without SS/​cSAH (time to event: 25 months) (p = 0.001). The location of hemorrhages on follow-up scan was not in the same location of previously noted SS/cSAH in 9 of 10 patients. Follow-up imaging was obtained in 9 of 17 patients with cSAH and showed evidence of SS in the same location as initial cSAH in all these 9 cases. Conclusions: SS/cSAH is common in patients with suspected CAA without lobar intracerebral hemorrhage and may have a significantly higher risk of future cerebral bleeding events, regardless of the severity of the baseline CMB burden. The findings further highlight a precise anatomical correlation between TFNE and cSAH, but not SS. Distinct from transient ischemic attack or seizure, the majority of TFNE caused by SS/cSAH appear to present with spreading sensory symptoms.

Acute Convexity Subarachnoid Hemorrhage Related to Cerebral Amyloid Angiopathy: Clinicoradiological Features and Outcome

2016 ◽  
Vol 25 (5) ◽  
pp. 1009-1016 ◽  
Author(s):  
Lionel Calviere ◽  
Victor Cuvinciuc ◽  
Nicolas Raposo ◽  
Alexandre Faury ◽  
Christophe Cognard ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Cerebral Amyloid
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