Lobar cerebral hemorrhage from amyloid angiopathy: clinical, neuroimaging, pathologic and outcome correlations.

Abstract

Cerebral amyloid angiopathy (CAA) contributes to sporadic lobar intracerebral hemorrhage in older patients, especially those who are more than 70 years old. In clinical practice, a diagnosis of CAA refers to the Boston Criteria, which requires that "definitive" cases be confirmed by pathologic evidence at autopsy. A "Probable" case, means that there is clinical support and that pathologic evidence is available by biopsy from the craniotomy for patients with severe lobar intracerebral hemorrhage. Cerebral amyloid that is deposited in cortical vessels is revealed by apple-green birefringence under polarized light using Congo-red stain. Rebleeding after a first primary intracerebral hemorrhage is common. This paper describes five cases of aged patients with lobar cerebral hemorrhage and craniotomy with hematoma evacuation and biopsy. Pathological results all showed amyloid angiopathy. Various outcomes are discussed, and the literature is reviewed. Findings show that although patients with CAA were at high risk of recurrent hemorrhage after surgery, the mortality rate was relatively low despite the severity of lobar intracerebral hemorrhage.

• Authors: Chuang-Sin Chen, Yuk-Keung Lo, Sui-Hing Yan, Yuh-Te Lin, Ping-Hong Lai, Yu-Shing Lo
• Journal: Acta neurologica Taiwanica (Acta Neurol Taiwan) Vol. 13 Issue 1 Pg. 14-9 (Mar 2004) ISSN: 1028-768X [Print] China (Republic : 1949- )
• PMID: 15315296 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Brain (pathology)
• Cerebral Amyloid Angiopathy (complications, pathology, surgery)
• Cerebral Hemorrhage (etiology, pathology, surgery)
• Female
• Glasgow Coma Scale
• Humans
• Magnetic Resonance Imaging
• Male
• Neurosurgical Procedures
• Recurrence
• Tomography, X-Ray Computed
• Treatment Outcome