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Title: Amyloid-β (Aβ)-Related Cerebral Amyloid Angiopathy Causing Lobar Hemorrhage Decades After Childhood Neurosurgery.
Austin 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
Affiliation: Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Australia..
Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Australia..
Department of Neurosurgery, The Royal Melbourne Hospital, Australia..
Department of Pathology, The Royal Melbourne Hospital, Australia..
Molecular Imaging and Therapy
The Florey Institute of Neuroscience and Mental Health
Department of Anatomical Pathology, The Alfred Hospital, Australia..
Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Australia..
Issue Date: 2022 2022
Publication information: Stroke 2022-08; 53(8): e369-e374
Abstract: 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. 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. 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. Our findings support the concept of neurosurgical Aβ transmission but suggest that such cases are rare in standard clinical practice.
DOI: 10.1161/STROKEAHA.121.038364
ORCID: 0000-0001-9786-3096
Journal: Stroke
PubMed URL: 35770667
PubMed URL:
Type: Journal Article
Subjects: Alzheimer disease
cerebral amyloid angiopathy
cerebral hemorrhage
Appears in Collections:Journal articles

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