Detailed Clinical and MRI Characteristics in Primary Non-traumatic Convexity Subarachnoid Haemorrhage Elderly Patients.

Study Overview
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Brief Summary
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Transient focal neurological episode (TFNE) is the most frequent presenting symptom of convexity subarachnoid haemorrhage (cSAH) in elderly patients with non-traumatic cSAH with suspected, possible or probable cerebral amyloid angiopathy (CAA). The aim of our study was to analyse in detail clinical and MRI characteristics in these patients. Methods: We performed a retrospective study analysing baseline, acute clinical symptom (TFNE and headache), and MRI characteristics (acute cSAH and chronic CAA features) of consecutive elderly (≥55 years) patients, recruited and registered in the stroke database, between june 2008 and october 2020 of two centres (Nîmes and Montpellier University Hospital, France), presenting with cSAH with suspected, possible, or probable CAA.

Official Title
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Detailed Clinical and MRI Characteristics in Primary Non-traumatic Convexity Subarachnoid Haemorrhage Elderly Patients.

Conditions
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Cerebral Amyloid Angiopathy, Subarachnoid Hemorrhage

Intervention / Treatment
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* Other: usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥55 years of age, acute symptomatic cSAH based on FLAIR and T2*-weighted imaging performed within one month of symptom onset, recent trauma, anticoagulation treatment, pathological blood coagulation tests (activated partial thromboplastin time [aPTT] ratio=patient's aPTT/normal control aPTT] >1.2; or partial thromboplastin time [PTT] <75%) or platelet count (<100 x 109/L), Exclusion Criteria: exclusion of underlying non-CAA cSAH causes (e.g. reversible cerebral vasoconstriction syndrome, trauma, cerebral venous sinus thrombosus, aneurysm, primary angiitis of the central nervous system, anticoagulation treatment, pathological blood coagulation tests)

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Consecutive elderly (≥55 years) patients, recruited and registered in the stroke database of two centres (Nîmes University Hospital and Montpellier University Hospital, France), presenting with cSAH with suspected, possible, or probable CAA. | Other: usual care<br>* according to recommendations<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of MRI | Extent of acute cSAH (number of sulci, focal [≤3 sulci] or diffuse [>3 sulci], surface) | day of the diagnosis | 
| Description of MRI | the multifocality of acute cSAH (as described for cortical superficial siderosis (CSS)), sulci involved by cSAH, CSS presence, CSS extent (focal, ≤3 sulci; diffuse >3 sulci) | day of the diagnosis | 
| Description of MRI | cerebral microbleeds (CMB, <10 mm) presence | day of the diagnosis | 
| Description of MRI | cerebral microbleeds number | day of the diagnosis | 
| Description of MRI | cerebral microbleeds categorisation (according to the Microbleed Anatomical Rating Scale), | day of the diagnosis | 
| Description of MRI | presence and number of chronic lobar intracerebral haemorrhage (ICH) (>10 mm) | day of the diagnosis | 
| Description of MRI | Extent of white matter hyperintensities (periventricular Fazekas scale 0-3) | day of the diagnosis | 
| Clinical parameters | Transient focal neurological episode (TFNE) presence | day of the diagnosis | 
| Clinical parameters | number of TFNE preceding MRI | day of the diagnosis | 
| Clinical parameters | TFNE symptoms (sensory, motor, visual, speech; positive or negative symptoms | day of the diagnosis | 
| Clinical parameters | Presence and speed of spreading TFNE symptoms | day of the diagnosis | 
| Clinical parameters | Correlation of TFNE symptoms to cSAH localisation | day of the diagnosis | 
| Clinical parameters | headache (Yes/No) | day of the diagnosis | 
| Clinical parameters | antiepileptic drugs (AED) introduction and type of AED introduced | day of the diagnosis |