To investigate the clinical features and surgical treatment of cerebral amyloid angiopathy hemorrhage (CAAH) caused by cerebral vascular amyloidosis.

The 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.

The 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.

The 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.

Cerebral hemorrhage; Cerebral amyloid angiopathy; Microsurgery