|
|
Wat is het?
The Boston criteria are clinical and neuroimaging guidelines used to diagnose cerebral amyloid angiopathy (CAA) without needing brain tissue.
Updated to version 2.0, they help identify patients aged 50 and older presenting with lobar hemorrhages, transient spells, or cognitive decline.
|
Diagnostic Tiers (Boston Criteria 2.0)
- definite CAA: Autopsy or post-mortem exam shows severe CAA, vasculopathy, and lobar hemorrhage or cognitive loss with no other cause
- probable CAA with Supporting Pathology: Tissue from a biopsy or evacuated hematoma shows CAA alongside clinical symptoms
- probable CAA (No Tissue Needed): Age = 50 with clinical symptoms plus MRI showing:
- at least two strictly lobar hemorrhagic lesions (intracerebral hemorrhage, microbleeds, or cortical superficial siderosis); OR
- one lobar hemorrhagic lesion plus one white matter feature (severe perivascular spaces in the centrum semiovale [>20] or a multispot white matter hyperintensity pattern [>10 subcortical FLAIR dots])
- Possible CAA: Age = 50 with clinical symptoms plus MRI showing only one strictly lobar hemorrhagic lesion or one qualifying white matter feature
Key Exclusion Rules
- no deep hemorrhagic lesions (such as basal ganglia or thalamus) on T2*-weighted MRI
- absence of other known causes for the bleeding (e.g., trauma, active coagulopathy, or vascular malformation)
Bronnen:
|