{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:17:01Z","timestamp":1791951421379,"version":"4.3.4"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prion-like transmission of amyloid-\u00df through cadaveric dura, decades after neurosurgical procedures, has been hypothesized as an iatrogenic cause of cerebral amyloid angiopathy (CAA). We investigated new and previously described patients to assess the clinical profile, radiological features, and outcome of this presumed iatrogenic CAA-subtype (iCAA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients were collected from our prospective lobar hemorrhage and CAA database (n=251) with patients presenting to our hospital between 2008 and 2022. In addition, we identified patients with iCAA from 2 other Dutch CAA-expertise hospitals and performed a systematic literature-search for previously described patients. We classified patients according to the previously proposed diagnostic criteria for iCAA, assessed clinical and radiological disease features, and calculated intracerebral hemorrhage (ICH)-recurrence rates. We evaluated the spatial colocalization of cadaveric dura placement and CAA-associated magnetic resonance imaging markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 49 patients (74% men, mean age 43 years [range, 27\u201384]); 15 from our database (6% [95% CI, 3%\u201310%]; 45% of patients &lt;55 years), 3 from the 2 other CAA-expertise hospitals, and 31 from the literature. We classified 43% (n=21; 1 newly identified patient) as probable and 57% (n=28) as possible iCAA. Patients presented with lobar ICH (57%), transient focal neurological episodes (12%), or seizures (8%). ICH-recurrence rate in the new patients (16\/100 person-years [95% CI, 7\u201332], median follow-up 18 months) was lower than in the previously described patients (77\/100 person-years [95% CI, 59\u201399], median follow-up 18 months). One patient had a 10 year interlude without ICH-recurrence. We identified no clear spatial relationship between dura placement and CAA-associated magnetic resonance imaging markers. During follow-up (median, 18 months), 20% of the patients developed transient focal neurological episodes and 20% cognitively declined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>iCAA seems common in patients presenting with nonhereditary CAA under the age of 55. Clinical and radiological features are comparable with sCAA. After diagnosis, multiple ICH-recurrences but also long symptom-free intervals can occur. Harmonized registries are necessary to identify and understand this potentially underrecognized CAA-subtype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.122.041690","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T05:01:08Z","timestamp":1681102868000},"page":"1214-1223","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["Iatrogenic Cerebral Amyloid Angiopathy Post Neurosurgery: Frequency, Clinical Profile, Radiological Features, and Outcome"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1429-6853","authenticated-orcid":true,"given":"Kanishk","family":"Kaushik","sequence":"first","affiliation":[{"name":"Department of Neurology (K.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8301-6846","authenticated-orcid":true,"given":"Ellis S.","family":"van Etten","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-9142","authenticated-orcid":true,"given":"Bob","family":"Siegerink","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology (B.S.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-6630","authenticated-orcid":true,"given":"L. Jaap","family":"Kappelle","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Utrecht, the Netherlands (L.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8933-3260","authenticated-orcid":true,"given":"Afina W.","family":"Lemstra","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alzheimer center Amsterdam, Amsterdam University Medical Center, the Netherlands (A.W.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-0207","authenticated-orcid":true,"given":"Floris H.B.M.","family":"Schreuder","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, the Netherlands (F.H.B.M.S., C.J.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8495-4578","authenticated-orcid":true,"given":"Catharina J.M.","family":"Klijn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, the Netherlands (F.H.B.M.S., C.J.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilco C.","family":"Peul","sequence":"additional","affiliation":[{"name":"University Neurosurgical Center Holland, LUMC|HMC|HAGA Leiden &amp; The Hague, the Netherlands (W.C.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3140-6882","authenticated-orcid":true,"given":"Gisela M.","family":"Terwindt","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-229X","authenticated-orcid":true,"given":"Marianne A.A.","family":"van Walderveen","sequence":"additional","affiliation":[{"name":"Department of Radiology (M.A.A.v.W.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6838-9521","authenticated-orcid":true,"given":"Marieke J.H.","family":"Wermer","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0281-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-017-0503-z"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-016-1565-x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-016-1588-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1828-9"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25407"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-321927"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30238-6"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-017-1703-0"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature15369"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.01.051"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1822-2"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-019-0719-1"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-328792"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00208-3"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70124-8"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dad605"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2020.1854715"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03624.x"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514139"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-016-3004-0"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3109\/13506129.2012.746937"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrl.2021.05.006"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-021-04751-0"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.36959\/363\/420"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106260"},{"key":"e_1_3_3_29_2","first-page":"499","article-title":"Cerebral amyloid angiopathy: early presentation in a patient with prior neurosurgical interventions. Case report.","volume":"35","author":"Clark A","year":"2021","unstructured":"Clark, A, Barpujari, A, Lucke-Wold, B, Porche, K, Laurent, D, Koch, M, Decker, M. Cerebral amyloid angiopathy: early presentation in a patient with prior neurosurgical interventions. Case report. Rom Neurosurg. 2021;35:499\u2013502.","journal-title":"Rom Neurosurg"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.121.038364"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.inat.2020.100794"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-021-01252-0"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-018-0790-y"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/19336896.2016.1228507"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-015-1581-6"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2019.10.033"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2019.00315"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2004.tb05863.x"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.55.8.1075"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003486"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003181"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150170073"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.122.041690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:36:36Z","timestamp":1777491396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.122.041690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1161\/STROKEAHA.122.041690"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.122.041690","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-01","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}