J Korean Neurosurg Soc.  2015 Jul;58(1):30-35. 10.3340/jkns.2015.58.1.30.

Clinical Neuropathological Analysis of 10 Cases of Cerebral Amyloid Angiopathy-Related Cerebral Lobar Hemorrhage

Affiliations
  • 1Department of Neurology, The General Hospital of Shenyang Military Region, Shenyang, China. xiaoqiulicn@163.com
  • 2Department of Neurology, 463th Hospital of Chinese People's Liberation Army, Shenyang, China.

Abstract


OBJECTIVE
The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition.
METHODS
The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples.
RESULTS
The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases.
CONCLUSION
CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH.

Keyword

Cerebral amyloid angiopathy; Cerebral lobar hemorrhage; Neuropathology
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