Skip to main content
Log in

Surgical experience with massive lobar haemorrhage caused by cerebral amyloid angiopathy

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Nineteen patients with massive lobar haemorrhage without angiographic lesions received direct or stereotactic surgery, and biopsy specimens were examined histologically. Ten patients (53%) were found to have vessels positive for Congo-red staining, and demonstrating amyloid angiopathy. In the patients with amyloid angiopathy, CT scan and surgical findings were investigated. Subarachnoid haemorrhage (9/10), irregularly shaped haematoma (9/10) and fluid-blood density level in the haematoma cavity (7/10) were frequently found on CT scan. The characteristic surgical findings in patients treated by direct surgery were subarachnoid haemorrhage adjacent to intracerebral haematoma (8/8) and the existence of a tangle of vessels in the haematoma cavity (4/8). Evacuation of haematomas was relatively easy, and difficulty of haemostasis was not encountered during surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cosgrove GR, Leblanc R, Meagher-Viliemure K, Ethier R (1985) Cerebral amyloid angiopathy. Neurology 35: 625–663

    PubMed  Google Scholar 

  2. Gilles C, Brucher JM, Khoubesserian P, Vanderhaeghen JJ (1984) Cerebral amyloid angiopathy as a cause of multiple intracerebral haemorrhages. Neurology 34: 730–735

    PubMed  Google Scholar 

  3. Greene GM, Godersky JC, Biller J, Hart MN, Adams HP (1990) Surgical experience with cerebral amyloid angiopathy. Stroke 21: 1545–1549

    PubMed  Google Scholar 

  4. Ishii N, Nishihara Y, Horie A (1984) Amyloid angiopathy and lobar cerebral haemorrhage. J Neurol Neurosurg Psychiatry 47: 1203–1210

    PubMed  Google Scholar 

  5. Matkovic Z, Davis S, Gonzales M, Kalnins R, Masters CL (1991) Surgical risk of haemorrhage in cerebral amyloid angiopathy. Stroke 22: 456–461

    PubMed  Google Scholar 

  6. Ojeman RG, Heros RC (1983) Spontaneous brain haemorrhage. Stroke 14: 468–475

    PubMed  Google Scholar 

  7. Okazaki H, Reagan TJ, Campbell RJ (1979) Clinicopathologic studies of primary cerebral amyloid angiopathy. Mayo Clin Proc 54: 22–31

    PubMed  Google Scholar 

  8. Sobel DF, Baker E, Anderson B, Kretzschmar H (1985) Cerebral amyloid angiopathy associated with massive intracerebral haemorrhage. Neuroradiology 27: 318–321

    PubMed  Google Scholar 

  9. Tomonaga M (1981) Cerebral amyloid angiopathy in the elderly. J Am Geriatr Soc 29: 151–157

    PubMed  Google Scholar 

  10. Torack RM (1975) Congophilic angiopathy complicated by surgery and massive haemorrhage. A light and electron microscopic study. Am J Pathol 81: 349–366

    PubMed  Google Scholar 

  11. Tyler KL, Poletti CE, Heros RC (1982) Cerebral amyloid angiopathy with multiple intracerebral haemorrhage. J Neurosurg 57: 286–289

    PubMed  Google Scholar 

  12. Vinters HV (1987) Cerebral amyloid angiopathy: a critical review. Stroke 18: 311–324

    PubMed  Google Scholar 

  13. Wagle WA, Smith TW, Weiner M (1984) Intracerebral haemorrhage caused by cerebral amyloid angiopathy: radiographicpathologic correlation. AJNR 5: 171–176

    PubMed  Google Scholar 

  14. Wakai S, Kumakura N, Nagai M (1992) Lobar intracerebral haemorrhage: A clinical, radiographie, and pathological study of 29 consecutive operated cases with negative angiography. J Neurosurg 76: 231–238

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Minakawa, T., Takeuchi, S., Sasaki, O. et al. Surgical experience with massive lobar haemorrhage caused by cerebral amyloid angiopathy. Acta neurochir 132, 48–52 (1995). https://doi.org/10.1007/BF01404847

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01404847

Keywords

Navigation