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Intracerebral haemorrhage and cerebral amyloid angiopathy: CT features with pathological correlation

J H Miller1, J M Wardlaw, G A Lammie

  • 1Department of Radiology, University of Edinburgh, Western General Hospital, Scotland, UK.

Clinical Radiology
|August 7, 1999
PubMed

Insights

Computed tomography (CT) scans can reveal specific features of intracerebral hemorrhage linked to cerebral amyloid angiopathy (CAA). Recognizing these CT findings may improve in-life diagnosis of CAA, a condition often under-recognized.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Cerebral amyloid angiopathy (CAA) is a common cause of spontaneous intracerebral hemorrhage, particularly in the elderly.
  • Accurate in-life diagnosis of CAA is challenging, often relying on post-mortem confirmation.

Purpose of the Study:

  • To identify and review computed tomography (CT) features associated with pathologically confirmed cerebral amyloid angiopathy (CAA).
  • To enhance the recognition of CAA during life through characteristic CT findings in patients with intracerebral hemorrhage.

Main Methods:

  • Prospective collection of clinical and brain imaging records from patients with intracerebral hemorrhage and confirmed CAA post-mortem.
  • Review of brain CT scans to identify common features of hemorrhage and brain pathology in affected individuals.

Main Results:

  • Seven patients (aged 60-86) were studied over 30 months.
  • CT findings included large, lobar hemorrhages extending to the cortex, subarachnoid space, or ventricles.
  • Hemorrhages were often multiple and recurrent; blood density tended to sediment posteriorly.

Conclusions:

  • Specific CT features of intracerebral hemorrhage can suggest underlying cerebral amyloid angiopathy (CAA).
  • CAA associated with intracerebral hemorrhage may be under-recognized in clinical practice.
  • Consideration of these CT findings could improve the in-life diagnosis of CAA.
Abstract

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