Intracerebral hemorrhage caused by cerebral amyloid angiopathy: radiographic-pathologic correlation

Seven cases of nontraumatic intracerebral hemorrhage due to histologically confirmed cerebral amyloid angiopathy were observed over a period of 2 1/2 years. Initial computed tomographic (CT) scans demonstrated lobar hemorrhages in all but one patient, who had presented with corpus callosum hemorrhage. Superficial location, irregular borders, and surrounding edema were characteristic features. Angiography was performed in three cases. Findings included mass effect (three cases), opercular branch occlusion (one case), and pericallosal irregularity (one case), all in the areas of the hemorrhage. Clinically, none of the patients had a history of prior cerebrovascular disease. Mild hypertension had been present in three patients and dementia in two. These findings suggest that cerebral amyloid angiopathy is not a rare cause of atraumatic lobar hemorrhage, particularly in a normotensive, elderly population.