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Table 4 The modified Boston criteria for predicting the probability of Chronic Amyloid Angiopathy (CAA) as the underlying cause of ICH

From: Computed tomography in acute intracerebral hemorrhage: neuroimaging predictors of hematoma expansion and outcome

Modified Boston criteria

Definite CAA

Full post-mortem examination demonstrating:

  Lobar, cortical, or cortico-subcortical hemorrhage

  Severe CAA with vasculopathy

  Absence of other diagnostic lesion

Probable CAA with supporting pathology

Clinical data and pathologic tissue (evacuated hematoma or cortical biopsy) demonstrating:

  Lobar, cortical or cortical-subcortical hemorrhage (including ICH and/or CMB)

  Some degree of CAA in specimen

  Absence of other diagnostic lesion

Probable CAA

Clinical data and MRI or CT demonstrating:

  Multiple hemorrhages (ICH, CMB) restricted to lobar, cortical, or cortico-subcortical regions (cerebellar hemorrhages allowed),

  OR

  Single lobar, cortical or cortical-subcortical hemorrhage and cSS (focal or disseminated)

  Age ≥ 55 years

  Absence of other causes of hemorrhages* or cSS

Possible CAA

Clinical data and MRI or CT demonstrating:

 

  Single, lobar, cortical, or cortico-subcortical ICH, CMB;

 

  OR

 

  Presence of cSS (focal or disseminated)

 

  Age ≥ 55 years

 

  Absence of other causes of hemorrhages* or cSS

  1. *Other causes of hemorrhage (differential diagnosis of lobar hemorrhages): antecedent head trauma, hemorrhagic transformation of an ischemic stroke, arteriovenous malformation, hemorrhagic tumor, warfarin therapy with international normalization ratio > 3, and vasculitis. CAA: cerebral amyloid angiopathy; MRI: magnetic resonance imaging; ICH: intracerebral hemorrhage; cSS; cortical superficial siderosis; CMB: cerebral microbleeds