Edinburgh criteria for lobar intracerebral hemorrhage associated with cerebral amyloid angiopathy

The Edinburgh criteria were proposed in 2018 in order to diagnose lobar intracerebral hemorrhage associated with cerebral amyloid angiopathy (CAA) 1. They can potentially be used to rule CAA-associated lobar hemorrhage 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 hemorrhage 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 hemorrhage. The presence of subarachnoid hemorrhage 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 hemorrhage 1.

Simplified criteria

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

The presence of subarachnoid hemorrhage 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 hemorrhage. The presence of subarachnoid hemorrhage and finger-like projections from the intracerebral hemorrhage 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 hemorrhage 1.

Neurodegenerative diseases

Neurodegenerative diseases are legion and their classification just as protean. A useful approach is to divide them according to underlying pathological process, although even using this schema, there is much overlap and thus resulting confusion.

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Article information

rID: 58537
Synonyms or Alternate Spellings:
  • Edinburgh criteria
  • The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy

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Cases and figures

  • Case 1: high probability CAA (subarachnoid hemorrhage and finger-like projections)
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  • Case 2: high probability CAA (subrachnoid hemorrhage and APOE ɛ4)
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  • Case 3: high probability CAA (subrachnoid hemorrhage and APOE ɛ4)
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  • Case 4: high probability CAA (subrachnoid hemorrhage and APOE ɛ4)
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  • Case 5: low probability CAA (no subarachnoid hemorrhage or APOE ɛ4)
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  • Case 6: low probability CAA (no subarachnoid hemorrhage or APOE ɛ4)
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