Eventos neurológicos transitorios focales en pacientes con angiopatía amiloide cerebral

Abstract

Introduction

Cerebral amyloid angiopathy (CAA) is an age-related small vessel disease affecting cortical and leptomeningeal vessels. Recently, focal transient neurological episodes (FTNEs) have been described as a manifestation of CAA and are frequently misdiagnosed as transient ischemic attacks (TIAs). Previous studies estimated a prevalence of 10% for CAA-related FTNEs. The aim of our study was to investigate the prevalence of CAA in patients hospitalized for FTNEs initially interpreted as TIAs at a comprehensive stroke center.

Materials and methods

We conducted a retrospective observational study including consecutive patients aged 55 years or older who were admitted between May 2016 and December 2018 for FTNEs with complete symptom resolution within 24 hours. Continuous variables were compared using t tests, and categorical variables were analyzed using Fisher's exact test or the chi-square test, as appropriate. A p value < 0.05 was considered statistically significant.

Results

A total of 167 patients with FTNEs initially interpreted as TIAs were included, of whom 79 were women (47%), with a mean age of 73 ± 9 years. Applying the Boston criteria version 1.5, 44 patients (26%) met diagnostic criteria for CAA (15% possible, 11% probable). Patients with suspected CAA were older than those without CAA (mean age 76 vs. 71 years, p = 0.0285) and were more frequently male (68% vs. 47%, p = 0.0165). Coronary artery disease was more frequent in patients with suspected CAA than in those without CAA (32% vs. 12%, p = 0.0032).

Conclusions

To our knowledge, this is the first report on the prevalence of FTNEs in patients with findings compatible with CAA from a single comprehensive stroke center in the region, showing a prevalence of 26% when applying the Boston criteria version 1.5.