Edinburgh criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy

Dr Rohit Sharma and Dr Mark Rodrigues et al.

The Edinburgh criteria were proposed in 2018 in order to diagnose lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) 1. They can potentially be used to rule CAA-associated lobar haemorrhage either in or out, but require external validation in other patient populations before being used in clinical practice.

 

Criteria

Full criteria

The full Edinburgh criteria comprise of CT features combined with apolipoprotein E (APOE) genotype, and are divided into 3 tiers 1:

The presence of subarachnoid haemorrhage or APOE ɛ4 possession had 100% sensitivity for moderate/severe CAA in the development setting (95% CI 88 to 100).  Therefore the absence of these predictors (low probability CAA group) can rule-out cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage. The presence of subarachnoid haemorrhage and finger-like projections or APOE ɛ4 allele possession had 96% specificity  (95% CI 78 to 100). Therefore the presence of these predictors (high probability CAA group) can effectively rule-in cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage 1.

 

Simplified criteria

The simplified Edinburgh criteria comprise of CT features alone, and are divided into 3 tiers 1:

 

The presence of subarachnoid haemorrhage had 89% sensitivity for moderate/severe CAA in the development setting (95% CI 73 to 96).  Therefore the absence of this predictor (low probability CAA group) can effectively rule-out cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage. The presence of subarachnoid haemorrhage and finger-like projections from the intracerebral haemorrhage had 100% specificity  (95% CI 84 to 100). Therefore the presence of these predictors (high probability CAA group) can rule-in cerebral amyloid angiopathy-associated lobar intracerebral haemorrhage 1.

 

Source: Radiopaedia


Read the publication:

The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study

 

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