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European Journal of Neurology
Article . 2025 . Peer-reviewed
License: CC BY
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Iatrogenic Cerebral Amyloid Angiopathy in Patients Treated With Cadaveric Dura Mater During Childhood Neurosurgery: A Retrospective Cohort Study

A Retrospective Cohort Study
Authors: Pikija, S.; Toma, A.; Radlberger, R.; Griessenauer, C.J.; Hecker, C.; Trinka, E.; Ki, P.H.; +5 Authors

Iatrogenic Cerebral Amyloid Angiopathy in Patients Treated With Cadaveric Dura Mater During Childhood Neurosurgery: A Retrospective Cohort Study

Abstract

ABSTRACTBackgroundIatrogenic cerebral amyloid angiopathy (iCAA) is a recently identified clinico‐neuroradiological syndrome associated with medical procedures, particularly neurosurgical treatments involving cadaveric dura mater (e.g., Lyodura). iCAA can manifest as intracerebral hemorrhages, focal seizures, and cognitive impairment, with the risk following exposure currently unknown. We aim to evaluate the risk of developing iCAA in patients who underwent childhood neurosurgical treatment with Lyodura compared to those who did not.MethodsThis retrospective cohort study analyzed hospital records from the Christian‐Doppler University Hospital in Salzburg, along with mortality data provided by the Austrian Federal Institute of Statistics (Statistik Austria). The study included all patients aged 0–18 who underwent neurosurgical procedures between January 1970 and January 1996. The primary endpoint was the diagnosis of iCAA and iCAA‐related death.ResultsOf 569 pediatric neurosurgical patients, 388 (68%) were further analyzed. Four patients (1%) were diagnosed with probable iCAA at a median age of 42 years (IQR 40–47), with a median latency from surgery to symptom onset of 38 years (IQR 36–41). Only Lyodura recipients developed iCAA, with an incidence rate of 12% (OR 56, 95% CI: 6–2667). The overall incidence of symptomatic iCAA among recipients of any dura material was 5% (OR 19, 95% CI: 2–903).ConclusionsCadaveric dura mater, especially Lyodura, poses a long‐term risk for developing iCAA. Further research is needed to determine susceptibility factors in Lyodura‐exposed individuals.

Country
Netherlands
Keywords

Male, Adult, Adolescent, Iatrogenic Disease, Lyodura, Neurosurgical Procedures, Cohort Studies, Young Adult, Postoperative Complications, iatrogenic cerebral amyloid angiopathy, Cadaver, Humans, neurosurgery, Child, Retrospective Studies, cadaveric dura mater, iCAA, Infant, Newborn, Infant, Middle Aged, amyloid-beta, Cerebral Amyloid Angiopathy, pediatric, Child, Preschool, Austria, Original Article, Female, Dura Mater, retrospective cohort studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
4
Top 10%
Average
Top 10%
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