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One Hundred Cerebral Microhemorrhages: Rethinking Cerebral Amyloid Angiopathy in the Era of Amyloid-Targeted Antibodies
Navarra AN, Petrella JR, Liu AJ, Ikramuddin SS, Doraiswamy PM.. Cureus, 2026-03-12
Topic: Amyloid, tau and blood-test diagnosis
We report a case of probable cerebral amyloid angiopathy (CAA) presenting with almost 100 cerebral microhemorrhages in an apolipoprotein E 4 (APOE4) homozygous subject with mild cognitive impairment (MCI). CAA is highly prevalent in autopsy studies and may impact over 100 million individuals worldwide; however, it remains substantially underdiagnosed clinically. CAA raises the risk for intracerebral hemorrhages as well as amyloid-related imaging abnormalities (ARIA) with amyloid-targeted antibodies. CAA is especially a quandary in APOE4 homozygotes who are at greatest risk for both Alzheimer's disease (AD) and ARIA. This case highlights the urgent need for greater diagnostic awareness and therapeutic development.
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APA 7th
Navarra, A. N., Petrella, JR., Liu, A. J., Ikramuddin, S. S., & Doraiswamy, P. M. (2026). One Hundred Cerebral Microhemorrhages: Rethinking Cerebral Amyloid Angiopathy in the Era of Amyloid-Targeted Antibodies. Cureus. https://doi.org/10.7759/cureus.105106
Vancouver
Navarra AN, Petrella JR, Liu AJ, Ikramuddin SS, Doraiswamy PM. One Hundred Cerebral Microhemorrhages: Rethinking Cerebral Amyloid Angiopathy in the Era of Amyloid-Targeted Antibodies. Cureus. 2026. doi:10.7759/cureus.105106. PMID: 41994695.
BibTeX
@article{navarra2026-41994695,
author = {Navarra, A. N. and Petrella, JR. and Liu, A. J. and Ikramuddin, S. S. and Doraiswamy, P. M.},
title = {{One Hundred Cerebral Microhemorrhages: Rethinking Cerebral Amyloid Angiopathy in the Era of Amyloid-Targeted Antibodies}},
journal = {Cureus},
year = {2026},
doi = {10.7759/cureus.105106},
pmid = {41994695},
url = {https://doi.org/10.7759/cureus.105106}
}
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Key findings
- We report a case of probable cerebral amyloid angiopathy (CAA) presenting with almost 100 cerebral microhemorrhages in an apolipoprotein E 4 (APOE4) homozygous subject with mild cognitive impairment (MCI).
- CAA is highly prevalent in autopsy studies and may impact over 100 million individuals worldwide; however, it remains substantially underdiagnosed clinically.
- CAA raises the risk for intracerebral hemorrhages as well as amyloid-related imaging abnormalities (ARIA) with amyloid-targeted antibodies.
- CAA is especially a quandary in APOE4 homozygotes who are at greatest risk for both Alzheimer's disease (AD) and ARIA.
- This case highlights the urgent need for greater diagnostic awareness and therapeutic development.
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Study details
- Evidence strengthLow
How this study scored 52/100
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 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Cureus) |
| 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 | 5 / 5 | 2026 — within 1 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 41994695) |
| Free to read | 2 / 2 | Free to read |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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