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Visualization of Amyloid β Deposits in the Human Brain with Matrix-assisted Laser Desorption/Ionization Imaging Mass Spectrometry
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Lobar cerebral hemorrhage from amyloid angiopathy: clinical, neuroimaging, pathologic and outcome correlations

Chuang-Sin Chen1, Yuk-Keung Lo, Sui-Hing Yan

  • 1Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan.

Acta Neurologica Taiwanica
|August 19, 2004
PubMed

Insights

Cerebral amyloid angiopathy (CAA) is linked to brain hemorrhages in elderly patients. Despite high rebleeding risks after surgery, these patients showed a surprisingly low mortality rate in this study.

Area of Science:

  • Neurology
  • Pathology
  • Neurosurgery

Background:

  • Cerebral amyloid angiopathy (CAA) is a significant cause of lobar intracerebral hemorrhage (ICH) in elderly individuals.
  • The Boston Criteria are used for diagnosing CAA, requiring pathological confirmation.
  • Recurrent hemorrhage is a common complication following an initial ICH event.

Purpose of the Study:

  • To describe outcomes in elderly patients with lobar ICH and CAA who underwent craniotomy for hematoma evacuation and biopsy.
  • To review the literature on CAA, ICH, and surgical management.

Main Methods:

  • Case series of five elderly patients with lobar ICH and confirmed CAA via biopsy.
  • Surgical intervention included craniotomy for hematoma evacuation.
  • Pathological examination using Congo-red stain and polarized light to identify cerebral amyloid deposition.

Main Results:

  • All five patients were diagnosed with cerebral amyloid angiopathy.
  • Despite the severity of ICH and surgical intervention, the observed mortality rate was relatively low.
  • Patients with CAA demonstrated a high risk of recurrent hemorrhage post-surgery.

Conclusions:

  • Craniotomy with hematoma evacuation can be considered in select elderly patients with lobar ICH and CAA.
  • While rebleeding risk is elevated, surgical intervention may be associated with favorable survival outcomes.
  • Further research is warranted to optimize management strategies for ICH secondary to CAA.

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