Amyloid-β (Aβ)-Related Cerebral Amyloid Angiopathy Causing Lobar Hemorrhage Decades After Childhood Neurosurgery. Issue 8 (30th June 2022)

• Record Type: Journal Article
• Authors: Kellie, Jeremy F.; Campbell, Bruce C.V.; Watson, Rosie; Praeger, Adrian J.; Nair, Girish; Murugasu, Anand; Rowe, Christopher C.; Masters, Colin L.; Collins, Steven; McLean, Catriona; Yassi, Nawaf
• Is Part Of: Stroke. Volume 53:Issue 8(2022)
• Page Start: e369
• Page End: e374
• Publication Date: 2022-06-30
• Subjects: Alzheimer disease -- cerebral amyloid angiopathy -- cerebral hemorrhage -- Lyodura -- neurosurgery; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.121.038364
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background: Recent reports raise the possibility of cerebral amyloid angiopathy (CAA) leading to intracerebral hemorrhage in young adults following childhood neurosurgery, suggesting transmission of amyloid-β (Aβ) through neurosurgical procedures including dura mater grafting. Parenchymal Aβ deposition, and to a lesser extent tau aggregation, similar to that seen in Alzheimer disease, have also been described. Methods: We conducted a database review of 634 consecutive intracerebral hemorrhage patients aged <65 years at a tertiary stroke center over 20 years to identify such patients. Results: We identified 3 patients aged in their thirties who presented with spontaneous lobar intracerebral hemorrhage, with imaging or neuropathology consistent with CAA, and a history of childhood neurosurgery. Two of these patients had undergone a dural repair using cadaveric dura mater (Lyodura). In addition to CAA, both patients had neuropathologically confirmed parenchymal Aβ and tau deposits, characteristic of Alzheimer disease. Conclusions: Our findings support the concept of neurosurgical Aβ transmission but suggest that such cases are rare in standard clinical practice.