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Multiple ischemic strokes in a patient treated with Lecanemab: a case report
Alammar H, Diallo M, Llano DA.. Neurocase, 2025-10-16
Topic: Brain proteins, microglia and lab models
Amyloid-lowering therapy via administration of monoclonal antibodies against amyloid beta has been previously associated with the formation of cerebral edema and/or microhemorrhage. These changes are often picked up on MRI and referred to as amyloid-related imaging abnormalities, or ARIA. Cerebral ischemia has not been systematically reported in clinical trials involving amyloid-lowering therapy but has been reported in case reports. Here we describe an additional case of a patient with Alzheimer's Disease treated with the amyloid-lowering drug Lecanemab who developed both ARIA-H and ARIA-E, as well as multiple asymptomatic ischemic infarctions. Extensive workup did not reveal another clear cause for infarction. These infarcts, in conjunction with previous reports of ischemic infarction in the setting of anti-amyloid therapy, suggest that amyloid-lowering therapy may predispose individuals to both hemorrhagic and ischemic infarction. This result is discussed in the context of microvascular pathology known to occur in the setting of Alzheimer's Disease.
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APA 7th
Alammar, H., Diallo, M., & Llano, D. A. (2025). Multiple ischemic strokes in a patient treated with Lecanemab: a case report. Neurocase. https://doi.org/10.1080/13554794.2025.2566151
Vancouver
Alammar H, Diallo M, Llano DA. Multiple ischemic strokes in a patient treated with Lecanemab: a case report. Neurocase. 2025. doi:10.1080/13554794.2025.2566151. PMID: 41102913.
BibTeX
@article{alammar2025-41102913,
author = {Alammar, H. and Diallo, M. and Llano, D. A.},
title = {{Multiple ischemic strokes in a patient treated with Lecanemab: a case report}},
journal = {Neurocase},
year = {2025},
doi = {10.1080/13554794.2025.2566151},
pmid = {41102913},
url = {https://doi.org/10.1080/13554794.2025.2566151}
}
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Key findings
- Amyloid-lowering therapy via administration of monoclonal antibodies against amyloid beta has been previously associated with the formation of cerebral edema and/or microhemorrhage.
- These infarcts, in conjunction with previous reports of ischemic infarction in the setting of anti-amyloid therapy, suggest that amyloid-lowering therapy may predispose individuals to both hemorrhagic and ischemic infarction.
- This result is discussed in the context of microvascular pathology known to occur in the setting of Alzheimer's Disease.
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Study details
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neurocase) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 4 / 5 | 2025 — within 3 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41102913) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
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