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Heterogeneous histopathology of cortical microbleeds in cerebral amyloid angiopathy
van Veluw SJ, Biessels GJ, Klijn CJ, Rozemuller AJ.. Neurology, 2016-02-03
Topic: Amyloid, tau and blood-test diagnosis
Objective To investigate the histopathologic substrate of microbleeds detected on 7T postmortem MRI in autopsy cases with severe cerebral amyloid angiopathy (CAA) and Alzheimer pathology. Methods Five decedents (mean age at death 79.6 ± 5.7 years) with documented severe CAA and Alzheimer pathology on standard neuropathologic examination were selected from a local database. Formalin-fixed coronal brain slices were scanned at 7T MRI, including high-resolution T2- and T2*-weighted sequences. Representative microbleeds from each case were sampled for histopathologic analysis, including the presence of blood, blood breakdown products, and markers of ischemic tissue injury. Results On MRI, we identified >300 cortical and 4 subcortical microbleeds. Two out of 15 sampled cortical microbleeds corresponded histologically to erythrocytes (suggestive of recent hemorrhages), 4 to vasculopathies (fibrinoid necrosis in 3 and a cavernoma) without substantial parenchymal tissue injury, and 9 to accumulations of iron-positive siderophages without erythrocytes (suggestive of old hemorrhages) combined with mild to moderate degrees of chronic ischemic tissue injury. Conclusions This study provides evidence for heterogeneous pathologic substrates and possibly different pathophysiologic mechanisms underlying MRI-observed cortical microbleeds in the context of advanced CAA and Alzheimer disease.
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APA 7th
van Veluw, S. J., Biessels, G. J., Klijn, C. J., & Rozemuller, A. J. (2016). Heterogeneous histopathology of cortical microbleeds in cerebral amyloid angiopathy. Neurology. https://doi.org/10.1212/wnl.0000000000002419
Vancouver
van Veluw SJ, Biessels GJ, Klijn CJ, Rozemuller AJ. Heterogeneous histopathology of cortical microbleeds in cerebral amyloid angiopathy. Neurology. 2016. doi:10.1212/wnl.0000000000002419. PMID: 26843561.
BibTeX
@article{vanveluw2016-26843561,
author = {van Veluw, S. J. and Biessels, G. J. and Klijn, C. J. and Rozemuller, A. J.},
title = {{Heterogeneous histopathology of cortical microbleeds in cerebral amyloid angiopathy}},
journal = {Neurology},
year = {2016},
doi = {10.1212/wnl.0000000000002419},
pmid = {26843561},
url = {https://doi.org/10.1212/wnl.0000000000002419}
}
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Key findings
- Results On MRI, we identified >300 cortical and 4 subcortical microbleeds.
Why it matters
This small autopsy study found that microbleeds seen on MRI in people with severe cerebral amyloid angiopathy and Alzheimer pathology had heterogeneous causes, including recent hemorrhage, vasculopathy, and old hemorrhage with ischemic injury. It helps explain what these MRI findings represent, but it does not test a treatment, cure, or prevention.
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Study details
- Evidence strengthLow
How this study scored 50/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported and randomized / 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 | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 88 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.3 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 4 / 6 | Cited 8.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Annemieke J.M. Rozemüller: h-index 73 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Utrecht University: institution h-index 1,157 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26843561) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 50 / 100 | — |
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Read the original
- DOI: 10.1212/wnl.0000000000002419
- PubMed: 26843561
- Original source →
- Free full text: Pure Amsterdam UMC →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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