{
  "abstract": "Background We aimed to describe neuroimaging features, clinical profiles and long-term outcomes in patients with iatrogenic cerebral amyloid angiopathy (iCAA).Methods We performed a systematic literature search for case series of iCAA and included individual patients and their longitudinal clinical and neuroimaging data in this pooled cohort study. Patients meeting a modified version of the Queen Square criteria for iCAA were included. Baseline and follow-up MRIs were centrally analysed for markers of CAA using validated rating scales.Results We included 51 patients (68.6% male, median age at presentation 48 years), 51.0% with probable and 49.0% with possible iCAA. We evaluated 219 MRIs acquired over a median follow-up time of 3.7 years (IQR 1.8–6.4). There were 43 symptomatic intracerebral haemorrhages (ICH) in 24 patients during follow-up, a rate of 16.7 per 100 patient-years.Patients with previous supratentorial brain surgery had an ipsilateral-dominant distribution and spread of haemorrhagic markers on MRI. 14/51 (27.5%) patients had transient inflammatory changes (cortical or parenchymal oedema, sulcal hyperintensities). Haemorrhagic markers progressed during follow-up. In addition to 43 symptomatic ICH, 36 asymptomatic ICH (mostly smaller intragyral haemorrhages) were detected on follow-up scans. Besides numerous lobar microbleeds (median 16 at baseline, 53 at last follow-up), deep microbleeds were present in 19.6% of patients at baseline and 44.4% at follow-up. Severe perivascular spaces in centrum semiovale were common at baseline (64.7%) and follow-up (95.6%).Conclusions Patients with iCAA appear to have distinctive MRI characteristics, which might differentiate iCAA from other CAA subtypes and provide new insights into underlying disease mechanisms.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria",
        "Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK"
      ],
      "name": "Simon Fandler-Höfler"
    },
    {
      "affiliations": [
        "Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Kanishk Kaushik"
    },
    {
      "affiliations": [
        "Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy"
      ],
      "name": "Benedetta Storti"
    },
    {
      "affiliations": [
        "Department of Neurology, Paracelsus Medical University, Salzburg, Austria"
      ],
      "name": "Slaven Pikija"
    },
    {
      "affiliations": [
        "Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK"
      ],
      "name": "Dermot Mallon"
    },
    {
      "affiliations": [
        "Department of Statistical Science, University College London, London, UK"
      ],
      "name": "Gareth Ambler"
    },
    {
      "affiliations": [
        "Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy"
      ],
      "name": "Payam Tabaee Damavandi"
    },
    {
      "affiliations": [
        "Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK",
        "Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine"
      ],
      "name": "Larysa Panteleienko"
    },
    {
      "affiliations": [
        "Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy"
      ],
      "name": "Isabella Canavero"
    },
    {
      "affiliations": [
        "Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Marianne A A van Walderveen"
    },
    {
      "affiliations": [
        "Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Ellis S van Etten"
    },
    {
      "affiliations": [
        "Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy"
      ],
      "name": "Jacopo Cosimo DiFrancesco"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Christian Enzinger"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Thomas Gattringer"
    },
    {
      "affiliations": [
        "Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy"
      ],
      "name": "Anna Bersano"
    },
    {
      "affiliations": [
        "Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands",
        "Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands"
      ],
      "name": "Marieke J H Wermer"
    },
    {
      "affiliations": [
        "Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK",
        "MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK"
      ],
      "name": "Gargi Banerjee"
    },
    {
      "affiliations": [
        "Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK"
      ],
      "name": "David J Werring"
    }
  ],
  "title": "Clinical-radiological presentation and natural history of iatrogenic cerebral amyloid angiopathy",
  "uid": "196f7923-ae1e-5f1f-b743-009c0256bfa0"
}