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Silent ischemic infarcts are associated with hemorrhage burden in cerebral amyloid angiopathy
Kimberly WT, Gilson A, Rost NS, Rosand J, Viswanathan A, Smith EE, Greenberg SM.. Neurology, 2009-04-01
Topic: Amyloid, tau and blood-test diagnosis
Background Neuropathologic studies suggest an association between cerebral amyloid angiopathy (CAA) and small ischemic infarctions as well as hemorrhages. We examined the prevalence and associated risk factors for infarcts detected by diffusion-weighted imaging (DWI). Methods We performed retrospective analysis of MR images from 78 subjects with a diagnosis of probable CAA and a similar aged group of 55 subjects with Alzheimer disease or mild cognitive impairment (AD/MCI) for comparison. DWI and apparent diffusion coefficient (ADC) maps were inspected for acute or subacute infarcts. We also examined the association between DWI lesions and demographic variables, conventional vascular risk factors, and radiographic markers of CAA severity such as number of hemorrhages on gradient-echo MRI and volume of T2-hyperintense white matter lesions. Results Twelve of 78 subjects with CAA (15%) had a total of 17 DWI-hyperintense lesions consistent with subacute cerebral infarctions vs 0 of 55 subjects with AD/MCI (p = 0.001). The DWI lesions were located primarily in cortex and subcortical white matter. CAA subjects with DWI lesions had a higher median number of total hemorrhages (22 vs 4, p = 0.025) and no difference in white matter hyperintensity volume or conventional vascular risk factors compared to subjects with CAA without lesions. Conclusions MRI evidence of small subacute infarcts is present in a substantial proportion of living patients with advanced cerebral amyloid angiopathy (CAA). The presence of these lesions is associated with a higher burden of hemorrhages, but not with conventional vascular risk factors. This suggests that advanced CAA predisposes to ischemic infarction as well as intracerebral hemorrhage.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Kimberly, W. T., Gilson, A., Rost, N. S., Rosand, J., Viswanathan, A., Smith, E. E., et al. (2009). Silent ischemic infarcts are associated with hemorrhage burden in cerebral amyloid angiopathy. Neurology. https://doi.org/10.1212/01.wnl.0000345666.83318.03
Vancouver
Kimberly WT, Gilson A, Rost NS, Rosand J, Viswanathan A, Smith EE, et al. Silent ischemic infarcts are associated with hemorrhage burden in cerebral amyloid angiopathy. Neurology. 2009. doi:10.1212/01.wnl.0000345666.83318.03. PMID: 19349602.
BibTeX
@article{kimberly2009-19349602,
author = {Kimberly, W. T. and Gilson, A. and Rost, N. S. and Rosand, J. and Viswanathan, A. and Smith, E. E. and Greenberg, S. M.},
title = {{Silent ischemic infarcts are associated with hemorrhage burden in cerebral amyloid angiopathy}},
journal = {Neurology},
year = {2009},
doi = {10.1212/01.wnl.0000345666.83318.03},
pmid = {19349602},
url = {https://doi.org/10.1212/01.wnl.0000345666.83318.03}
}
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 names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results Twelve of 78 subjects with CAA (15%) had a total of 17 DWI-hyperintense lesions consistent with subacute cerebral infarctions vs 0 of 55 subjects with AD/MCI (p = 0.001).
- CAA subjects with DWI lesions had a higher median number of total hemorrhages (22 vs 4, p = 0.025) and no difference in white matter hyperintensity volume or conventional vascular risk factors compared to subjects with CAA without lesions.
- The presence of these lesions is associated with a higher burden of hemorrhages, but not with conventional vascular risk factors.
- This suggests that advanced CAA predisposes to ischemic infarction as well as intracerebral hemorrhage.
Why it matters
Among people with probable cerebral amyloid angiopathy, 15% had small subacute infarcts on MRI, and those with infarcts had more hemorrhages than those without. This is about a related blood vessel condition, not about treating, curing, or preventing Alzheimer's disease.
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Study details
- Participants78
- Evidence strengthLow
How this study scored 55/100
Published in a leading specialty journal. Scored zero for study design, effect reported and 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 | 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 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 78 participants |
| 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 (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 234 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.3 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 4 / 6 | Cited 11.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Steven Mark Greenberg: h-index 144 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19349602) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/01.wnl.0000345666.83318.03
- PubMed: 19349602
- Original source →
- Free full text: Neurology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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