title: Superficial siderosis is a warning sign for future intracranial hemorrhage.
abstract: Supratentorial superficial siderosis (SS) is a frequent imaging marker of cerebral amyloid angiopathy (CAA). It is most probably caused by focal subarachnoid hemorrhages (fSAHs). Based on single-case observations, it has been proposed that such fSAHs might be a predisposing factor for future intracranial hemorrhage. Here we tested the hypothesis if a SS as a residue of fSAHs must be regarded as a warning sign for future intracranial hemorrhage. Fifty-one consecutive patients with SS and no apparent cause other than possible or probable CAA were identified through a database search and followed-up for a median interval of 35.3 months (range 6-120 months). Main outcome measures were rate and location of new intracranial hemorrhages. Twenty-four patients (47.1 %) had experienced any new intracranial hemorrhage, 18 patients (35.3 %) had an intracerebral hemorrhage (ICH), and in 13 of them (25.5 %), the hemorrhage was located at the site of pre-existing siderosis. Six patients (11.7 %) had developed a new subarachnoid hemorrhage (SAH), four of them at the site of siderosis. Patients with SS are at substantial risk for subsequent intracranial hemorrhage. SS can be considered a warning sign of future ICH or SAH, which frequently occur adjacent to pre-existing SS. Prospective studies are needed to confirm these findings.
authors: Department of Neuroradiology, University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany. jennifer.linn@med.uni-muenchen.de
authors: Jennifer
authors: J
authors: Linn
authors: Frank A
authors: FA
authors: Wollenweber
authors: Nina
authors: N
authors: Lummel
authors: Katja
authors: K
authors: Bochmann
authors: Thomas
authors: T
authors: Pfefferkorn
authors: Andreas
authors: A
authors: Gschwendtner
authors: Hartmut
authors: H
authors: Bruckmann
authors: Martin
authors: M
authors: Dichgans
authors: Christian
authors: C
authors: Opherk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012806:Siderosis / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed