Despite its clinical relevance, cerebral amyloid angiopathy (CAA) is underdiagnosed worldwide. This retrospective study aimed to assess the incidence, etiology, predictors, and outcome of intracerebral hemorrhages (ICHs) in this region, with special focus on possible underlying CAA. Database screening of acute cares with intracranial hemorrhage diagnosis within 01/07/2014-01/07/2018 were conducted analyzing medical records and imaging. Spontaneous ICHs were classified as deep (basal ganglionic/thalamic/brainstem) and lobar/cerebellar (i.e., CAA-compatible) ICHs. Probable/definite CAA was established using the modified Boston criteria in a subgroup with 'complete' radiological/neuropathological work-up. The ability of several factors to discriminate between deep and lobar/cerebellar ICHs, between probable/definite CAA and non-probable CAA cases, and to predict 1-month case fatality was assessed. Of the 213 ICHs identified, 121 were in deep and 92 in lobar/cerebellar localization. Sub-analysis of 47 lobar/cerebellar ICHs with 'complete' work-up identified 16 probable/definite CAA patients, yielding an estimated 14.7% prevalence of CAA-related ICHs. Chronic hypertension was the most prevalent risk factor for all types of ICHs (including CAA-related), with hypertensive excess and younger age being independent predictors of deep whereas antiplatelet use of lobar/cerebellar localization. The 1-month case fatality was 33.8%, driven predominantly by age and INR > 1.4. Probable/definite CAA diagnosis was independently predicted by age, prior intracranial hemorrhage, and antiplatelet use. First in this region and among the few in the literature, this study reports a remarkable prevalence of CAA-related ICHs, emphasizing the need for an increased awareness of CAA and its therapeutic implications, especially regarding antiplatelets among the elderly.

中文翻译：

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自发性脑出血的定位、结果和病因预测因素：关注脑淀粉样血管病。

尽管具有临床相关性，但脑淀粉样血管病 (CAA) 在世界范围内诊断不足。这项回顾性研究旨在评估该地区脑出血 (ICH) 的发生率、病因、预测因素和结果，特别关注可能的潜在 CAA。对 01/07/2014-01/07/2018 内诊断为颅内出血的急性护理进行数据库筛选，分析医疗记录和影像。自发性 ICH 分为深部（基底神经节/丘脑/脑干）和大叶/小脑（即 CAA 兼容）ICH。可能/确定的 CAA 是使用修改后的波士顿标准在“完整”放射学/神经病理学检查的亚组中建立的。几个因素区分深部和大叶/小脑 ICH 的能力，评估了可能/确定的 CAA 和非可能 CAA 病例之间的差异，并评估了 1 个月的病死率。在确定的 213 个 ICH 中，121 个位于深部，92 个位于大叶/小脑定位。对 47 例“完全”检查的大叶/小脑 ICH 进行的子分析确定了 16 例可能/确定的 CAA 患者，估计 CAA 相关 ICH 的患病率为 14.7%。慢性高血压是所有类型 ICH（包括 CAA 相关）最普遍的危险因素，高血压过度和年轻是大叶/小脑定位的深度和抗血小板使用的独立预测因素。1 个月的病死率为 33.8%，主要由年龄和 INR > 1.4 驱动。年龄、既往颅内出血和抗血小板药物使用独立预测可能/明确的 CAA 诊断。