ABSTRACT NUMBER: ESOC2026A1905 NEUROIMAGING PROFILES AND RISK OF RECURRENT INTRACEREBRAL HAEMORRHAGE IN PATIENTS WITH CEREBRAL AMYLOID ANGIOPATHY PRESENTING WITH INTRACEREBRAL VERSUS CONVEXITY SUBARACHNOID HAEMORRHAGE

Abstract Background and aims Acute haemorrhagic manifestations of cerebral amyloid angiopathy (CAA) include intracerebral haemorrhage (ICH) and convexity subarachnoid haemorrhage (cSAH), both of which are associated with high risk of recurrent intracranial haemorrhage. However, it is uncertain whether the neuroimaging profile and recurrence risk between patients presenting with CAA-related ICH or cSAH differs. Methods We included patients who presented with first-ever symptomatic ICH or cSAH over a 14-year period with available MRI meeting the modified Boston criteria (v2.0) for probable CAA. We investigated differences in cerebrovascular risk factors, neuroimaging findings including cerebral microbleeds (CMBs), cortical superficial siderosis (CSS), white matter hyperintensities (WMH) and their patterns and risk of recurrent ICH. Results We identified 125 patients (mean age 73.9 years) with CAA-related intracranial haemorrhage (105 with ICH, 20 with cSAH). Patients with cSAH tended to be older (median age 77.0 vs. 73.3 years, p=0.06), with no differences in clinical risk factors. We found no statistically significant differences in the prevalence of CMBs in patients with ICH vs. cSAH (71.4% vs. 70.0%, p=0.84) or the presence of CSS (55.2% vs. 70.0%, p=0.22). WMH and their patterns and enlarged perivascular spaces in the centrum semiovale also had similar prevalences. Over a median follow-up period of 3.4 years, 50 patients (40.0%) had a recurrent ICH; this risk was similar for patients presenting with ICH and cSAH (40.0% vs. 40.0%, p=1.00). Conclusions We found no major differences in clinical factors, neuroimaging and ICH recurrence risk in patients with CAA presenting with ICH or cSAH. Conflict of interest Linda Fabisch: nothing to disclose, Eva Pommer: nothing to disclose, Markus Kneihsl: nothing to disclose, Gerit Wünsch: nothing to disclose, Christian Enzinger: nothing to disclose, Thomas Gattringer: nothing to disclose, David Werring: nothing to disclose, Simon Fandler-Höfler: nothing to disclose