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Association Between Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage
Wells Andres, Samuel S. Bruce, Alexander Eliot Merkler, Costantino Iadecola, Mony J. de Leon, Gloria Chia-Yi Chiang, Hooman Kamel, Cenai Zhang et al.. Neurology, 2025-05-08
Topic: Amyloid, tau and blood-test diagnosis
Among 8.5 million hospitalized patients aged 50 years or older, 2,335 had CAA and 600,646 had other CVDs. During a median follow-up of 2.0 years (interquartile range 1.0-3.9), incident SDH occurred in 34 patients with CAA (1.5%), 3,552 patients with other CVDs (0.6%), and 35,425 patients without CAA or other CVDs (0.4%). In adjusted Cox regression analysis, there was an increased risk of incident SDH seen with CAA (hazard ratio [HR] 3.1; 95% CI 2.2-4.4) and with prevalent CVD (HR 1.4; 95% CI 1.3-1.5). Findings were similar in sensitivity analyses excluding patients with dementia. In a large, heterogeneous cohort, we found that CAA was associated with a 3-fold heightened risk of SDH, higher than the increased risk seen in patients with other CVDs. These findings support the emerging hypothesis that CAA is a risk factor of isolated nontraumatic SDH.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Andres, W., Bruce, S. S., Merkler, A. E., Iadecola, C., de Leon, M. J., Chiang, G. C.-Y., et al. (2025). Association Between Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage. Neurology. https://doi.org/10.1212/wnl.0000000000213614
Vancouver
Andres W, Bruce SS, Merkler AE, Iadecola C, de Leon MJ, Chiang GC.-Y, et al. Association Between Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage. Neurology. 2025. doi:10.1212/wnl.0000000000213614. PMID: 40340380.
BibTeX
@article{andres2025-40340380,
author = {Andres, Wells and Bruce, Samuel S. and Merkler, Alexander Eliot and Iadecola, Costantino and de Leon, Mony J. and Chiang, Gloria Chia-Yi and Kamel, Hooman and Zhang, Cenai and others},
title = {{Association Between Cerebral Amyloid Angiopathy and Nontraumatic Subdural Hemorrhage}},
journal = {Neurology},
year = {2025},
doi = {10.1212/wnl.0000000000213614},
pmid = {40340380},
url = {https://doi.org/10.1212/wnl.0000000000213614}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Among 8.5 million hospitalized patients aged 50 years or older, 2,335 had CAA and 600,646 had other CVDs.
- During a median follow-up of 2.0 years (interquartile range 1.0-3.9), incident SDH occurred in 34 patients with CAA (1.5%), 3,552 patients with other CVDs (0.6%), and 35,425 patients without CAA or other CVDs (0.4%).
- In adjusted Cox regression analysis, there was an increased risk of incident SDH seen with CAA (hazard ratio [HR] 3.1; 95% CI 2.2-4.4) and with prevalent CVD (HR 1.4; 95% CI 1.3-1.5).
- Findings were similar in sensitivity analyses excluding patients with dementia.
- In a large, heterogeneous cohort, we found that CAA was associated with a 3-fold heightened risk of SDH, higher than the increased risk seen in patients with other CVDs.
Why it matters
In a large cohort of hospitalized patients aged 50 or older, cerebral amyloid angiopathy was associated with about a threefold higher risk of nontraumatic subdural hemorrhage. This identifies CAA as a risk factor for bleeding but does not show how to treat, cure or prevent Alzheimer's disease.
Study details
- Study designcohort study
- Participants34
- Effect size1.5%; 0.6%; 0.4%
- Evidence strengthModerate
How this study scored 56/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 34 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 10 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Santosh B. Murthy: h-index 39 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Weill Cornell Medicine: institution h-index 1,163 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40340380) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
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