{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:59:34Z","timestamp":1792133974853,"version":"4.4.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cerebral amyloid angiopathy (CAA) most commonly presents with lobar intracerebral haemorrhage, though also with transient focal neurological episodes, cognitive impairment, as an incidental finding and rarely acutely or subacutely in patients developing an immune response to amyloid. Convexity subarachnoid haemorrhage, cortical superficial siderosis and lobar cerebral microbleeds are the other signature imaging features. The main implications of a diagnosis are the risk of intracerebral haemorrhage and frequent co-existence of antithrombotic indications. The risk of intracerebral haemorrhage varies by phenotype, being highest in patients with transient focal neurological episodes and lowest in patients with isolated microbleeds.<\/jats:p>\n               <jats:p>There is only one relevant randomised controlled trial to CAA patients with antithrombotic indications: RESTART showed that in patients presenting with intracerebral haemorrhage while taking antiplatelets, restarting treatment appeared to reduce recurrent intracerebral haemorrhage and improve outcomes. Observational and indirect data are reviewed relevant to other scenarios where there are antithrombotic indications. In patients with a microbleed-only phenotype, the risk of ischaemic stroke exceeds the risk of intracerebral haemorrhage at all cerebral microbleed burdens. In patients with atrial fibrillation (AF), left atrial appendage occlusion, where device closure excludes the left atrial appendage from the circulation, can be considered where the risk of anticoagulation seems prohibitive. Ongoing trials are testing the role of direct oral anticoagulant (DOACs) and left atrial appendage occlusion in patients with intracerebral haemorrhage\/AF but in the interim, treatment decisions will need to be individualised and remain difficult.<\/jats:p>","DOI":"10.1093\/ageing\/afaa275","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T20:22:37Z","timestamp":1610310157000},"page":"347-355","source":"Crossref","is-referenced-by-count":20,"title":["New horizons: managing antithrombotic dilemmas in patients with cerebral amyloid angiopathy"],"prefix":"10.1093","volume":"50","author":[{"given":"James","family":"Kelly","sequence":"first","affiliation":[{"name":"Hampshire Hospital Foundation Trust, Department of Elderly Care, Royal Hampshire County Hospital, Winchester, Hampshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"2021030604543594600_ref1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1136\/jnnp-2011-301308","article-title":"Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum","volume":"83","author":"Charidimou","year":"2012","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2021030604543594600_ref2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1017\/CBO9780511974892","volume-title":"Cerebral microbleeds: pathology to clinical practice","author":"Werring","year":"2011"},{"key":"2021030604543594600_ref3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-2990.2010.01137.x","article-title":"Sporadic cerebral amyloid angiopathy","volume":"37","author":"Attems","year":"2011","journal-title":"Neuropathol Appl Neurobiol"},{"key":"2021030604543594600_ref4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/jcbfm.2015.88","article-title":"Ischaemic brain injury in cerebral amyloid angiopathy","volume":"36","author":"Reijmer","year":"2016","journal-title":"J Cereb Blood Flow Metab"},{"key":"2021030604543594600_ref5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5853\/jos.2015.17.1.17","article-title":"Cerebral amyloid angiopathy: emerging concepts","volume":"17","author":"Yamada","year":"2015","journal-title":"J Stroke"},{"key":"2021030604543594600_ref6","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S1474-4422(18)30006-1","article-title":"The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic accuracy test","volume":"17","author":"Rodrigues","year":"2018","journal-title":"Lancet Neurol"},{"key":"2021030604543594600_ref7","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1161\/STROKEAHA.115.008778","article-title":"Contribution of convexal subarachnoid haemorrhage to disease progression in cerebral amyloid angiopathy","volume":"46","author":"Beitzke","year":"2015","journal-title":"Stroke"},{"key":"2021030604543594600_ref8","doi-asserted-by":"crossref","first-page":"e358","DOI":"10.1212\/WNL.0000000000007818","article-title":"APOE and cortical superficial siderosis in CAA: meta-analysis and potential mechanisms","volume":"93","author":"Charidimou","year":"2019","journal-title":"Neurology"},{"key":"2021030604543594600_ref9","doi-asserted-by":"crossref","DOI":"10.1002\/9780470905203","volume-title":"Susceptibility weighted imaging. 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