Table 2. Classification of ICH attributed to CAA (modified Boston criteria).
CAA score | Postmortem examinationa | Pathologic tissue (evacuated hematoma or cortical biopsy) | Lobar, cortical, or subcortical hemorrhage | Age ≥ 55y | Other diagnostic lesion (A1, A2a) Other cause of hemorrhage or siderosis (A2b, A3)b |
---|---|---|---|---|---|
A1 | + | +/- | + | + | - |
A2A with supporting pathology | - | + | + | + | - |
A2B | - | - | +c or d | + | - |
A3 | - | - | +e or f | + | - |
A1: CAA definite
A2A: CAA probable with supporting pathology
A2B: CAA probable
A3: CAA possible
a. Full postmortem examination demonstrating: 1) Lobar, cortical, or corticosubcortical hemorrhage; 2) Severe CAA with vasculopathy; and 3) Absence of other diagnostic lesion
b. Other causes of intracerebral hemorrhage: excessive warfarin (INR>3); antecedent head trauma or ischemic stroke; CNS tumour, vascular malformation, or vasculitis; and blood dyscrasia or coagulopathy. (INR>3 or other nonspecific laboratory abnormalities permitted for diagnosis of possible CAA.) [8]
c. Multiple hemorrhages restricted to lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed)
d. Single lobar, cortical, or corticosubcortical hemorrhage and focal (restricted to 3 or fewer sulci) or disseminated (affecting at least 4 sulci) superficial siderosis
e. Single lobar, cortical, or corticosubcortical hemorrhage
f. Focal (restricted to 3 or fewer sulci) or disseminated (affecting at least 4 sulci) superficial siderosis [9].