Inflammation in Cerebral Amyloid Angiopathy-Related Transient Focal Neurological Episodes

IF 8.1 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2025-01-08 DOI:10.1002/ana.27164

Amina Sellimi MD, Larysa Panteleienko MD, PhD, Dermot Mallon MD, PhD, Simon Fandler-Höfler MD, PhD, Rupert Oliver MD, PhD, Victoria Harvey Sc, PGDip, Michael S. Zandi PhD, Gargi Banerjee MD, PhD, David J. Werring MD, PhD

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Abstract

Transient focal neurological episodes (TFNE), often associated with convexity subarachnoid hemorrhage (cSAH), are common in cerebral amyloid angiopathy (CAA), but their pathophysiology remains incompletely understood. In six patients with unremitting TFNE, using high-resolution post-contrast magnetic resonance imaging and vessel wall imaging (VWI), we found various combinations of transient leptomeningeal, parenchymal and vessel wall enhancement; in 5 of 6 the enhancement included regions corresponding anatomically to symptoms. Three patients had resolution of TFNE and enhancement (2 with corticosteroid treatment, 1 without). Our observations suggest that inflammation might contribute to the pathophysiology of CAA-related TFNE and cSAH, with potential wider relevance for the associated high risks of recurrent ICH in CAA more generally. ANN NEUROL 2025;97:475–482

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脑淀粉样血管病相关短暂局灶性神经发作中的炎症。

短暂局灶性神经发作（TFNE）常与凸出性蛛网膜下腔出血（cSAH）相关，在脑淀粉样血管病（CAA）中很常见，但其病理生理机制尚不完全清楚。在6例持续性TFNE患者中，通过高分辨率磁共振成像和血管壁成像（VWI），我们发现短暂性脑膜、实质和血管壁增强的不同组合；6例中有5例的增强包括与症状解剖相对应的区域。3例患者TFNE消退和增强（2例接受皮质类固醇治疗，1例未接受治疗）。我们的观察结果表明，炎症可能有助于CAA相关的TFNE和cSAH的病理生理，并且与CAA中复发性脑出血的相关高风险具有更广泛的相关性。Ann neurol 2025。

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.