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Prevalence and clinical characteristics of cortical superficial siderosis in patients with acute stroke

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Abstract

Cortical superficial siderosis (cSS) is a pathologic and radiologic diagnosis of hemosiderin deposition in subpial brain layers. However, cSS has not been fully studied in patients with acute stroke. Here, we investigated the prevalence of cSS in patients with acute stroke and analyzed the relationship between cSS and different clinical and neuroimaging characteristics. From September 2014 through June 2016, consecutive patients with acute stroke who were admitted to our department were retrospectively investigated. We analyzed the prevalence of cSS and the associations between cSS and risk factors, the topographic distribution of cerebral microbleeds (CMBs), and the severity of white matter lesions (WMLs). In total, 739 patients (589 patients with ischemic stroke/transient ischemic stroke [IS/TIA] and 150 with intracerebral hemorrhage [ICH]; mean age, 71.4 years) were enrolled. We identified cSS in six (1.0%) patients with IS/TIA and seven (4.7%) patients with ICH. The presence of cSS was associated with ICH (P < 0.0001), WMLs (P = 0.0105), and lobar and non-lobar CMBs (both P < 0.0001); no associations between cSS and age, sex, cardiovascular risk factors, IS subtype classification, or antiplatelet and anticoagulant therapy were found. In a multivariable logistic regression analysis, high numbers of lobar CMBs (≥ 2; odds ratio, 11.03; 95% confidence interval, 2.03–205.40; P = 0.0029) were independently associated with cSS. Furthermore, cSS was often located near lobar CMBs. Our results suggest that cSS is prevalent in ICH and is independently associated with lobar CMBs; however, no associations between cSS and other risk factors or comorbidities were observed.

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Authors and Affiliations

  1. Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Satoshi Suda, Takashi Shimoyama, Shizuka Suzuki, Takahiro Ouchi, Masafumi Arakawa, Junya Aoki, Kentaro Suzuki, Yuki Sakamoto, Seiji Okubo, Yasuhiro Nishiyama, Chikako Nito, Masahiro Mishina & Kazumi Kimura

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  1. Satoshi Suda
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  2. Takashi Shimoyama
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  3. Shizuka Suzuki
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  4. Takahiro Ouchi
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  5. Masafumi Arakawa
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  7. Kentaro Suzuki
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Correspondence to Satoshi Suda.

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The authors declare no financial or other conflicts of interest.

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This study was conducted in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the ethics committee of Nippon Medical School and all participants or their family members provided written informed consent for participation.

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Suda, S., Shimoyama, T., Suzuki, S. et al. Prevalence and clinical characteristics of cortical superficial siderosis in patients with acute stroke. J Neurol 264, 2413–2419 (2017). https://doi.org/10.1007/s00415-017-8646-1

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  • DOI: https://doi.org/10.1007/s00415-017-8646-1

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