Short Article
Clinical characteristics and surgical treatment of cerebral amyloid angiopathy hemorrhage: an analysis of 76 cases
Du GuoSen, Zhao Ming, Xu Longbiao, Wei Chao, Wang Majun, Pan Bolin, He Chao, Wang Ning, Guo Xuanming, Wu Tianya
Published 2017-04-15
Cite as Chin J Neuromed, 2017,16(04): 416-418. DOI: 10.3760/cma.j.issn.1671-8925.2017.04.018
Abstract
ObjectiveTo investigate the clinical features and surgical treatment of cerebral amyloid angiopathy hemorrhage (CAAH) caused by cerebral vascular amyloidosis.
MethodsThe clinical data, radiological diagnoses, pathology results and treatment efficacies of 76 patients with CAAH, admitted to and performed surgery in our hospital from August 2010 to September 2015, were retrospectively analyzed.
ResultsThe first preoperative CT indicated that prompt hematomas were located in the cerebral hemisphere brain cortex, forming lobulated or irregular shape; 2 or more lesions of recurrent hemorrhage were noted in 14 (18.4%); 34 (44.7%) were with subarachnoid hemorrhage, 16 (21.1%) were with intraventricular hemorrhage. Histopathological examination supported the diagnosis. Sixteen patients (21.1%) underwent second operation during hospitalization due to large amount of bleeding. During hospitalization, 18 (23.7%) died, and 20 (26.3%) had long-term coma. During the follow-up period, 23 patients (30.3%) had recurrent intracranial hemorrhage, of which, 6 patients (7.9%) underwent surgical treatment, and 17 patients (22.4%) died.
ConclusionThe bleeding sites of CAAH mainly locate in the lobes of the brain surface, with lobulated or irregular shape, which is easily complicated with subarachnoid hemorrhage or intraventricular hemorrhage, with multiple features; diagnostic rate of CAAH can be improved by pathological examination of brain tissues and blood vessels; CAAH after surgery has high relapse rate and poor surgical results.
Key words:
Cerebral hemorrhage; Cerebral amyloid angiopathy; Microsurgery
Contributor Information
Du GuoSen
Department of Neurosurgery, Zhuji People's Hospital of Zhejiang Province, Zhuji 311800, China
Zhao Ming
Xu Longbiao
Wei Chao
Wang Majun
Pan Bolin
He Chao
Wang Ning
Guo Xuanming
Wu Tianya