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Boston criteria for cerebral amyloid angiopathy

The Boston criteria were first proposed in 1990 in order to standardise the diagnosis of cerebral amyloid angiopathy. They comprise of combined clinical, imaging and pathological parameters.

The criteria are divided into four tiers and are as 1-2:

  • definite cerebral amyloid angiopathy:
    • full post-mortem examination reveals lobar, cortical, or cortical/subcortical haemorrhage and pathological evidence of severe cerebral amyloid angiopathy
  • probable cerebral amyloid angiopathy with supporting pathological evidence:
    • clinical data and pathological tissue (evacuated haematoma or cortical biopsy specimen) demonstrate a haemorrhage as mendtioed above and some degree of vascular amyloid deposition
    • doesn't have to be post-mortem
  • probable cerebral amyloid angiopathy:
    • pathological confirmation not required
    • patient older than 55 years
    • appropriate clinical history 
    • MRI findings demonstrate multiple haemorrhages of varying sizes/ages with no other explanation 
  • possible cerebral amyloid angiopathy
    • patient older than 55 years
    • appropriate clinical history 
    • MRI findings reveal a single lobar, cortical, or cortical/subcortical haemorrhage without another cause, multiple haemorrhages with a possible but not a definite cause, or some haemorrhage in an atypical location

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