title: Surgical experience with massive lobar haemorrhage caused by cerebral amyloid angiopathy.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Niigata University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Minakawa
authors.forename: S
authors.initials: S
authors.lastname: Takeuchi
authors.forename: O
authors.initials: O
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Koizumi
authors.forename: Y
authors.initials: Y
authors.lastname: Honad
authors.forename: Y
authors.initials: Y
authors.lastname: Fujii
authors.forename: T
authors.initials: T
authors.lastname: Ozawa
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
authors.forename: T
authors.initials: T
authors.lastname: Koike
authors.forename: R
authors.initials: R
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016657:Cerebral Amyloid Angiopathy / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002536:Cerebral Arteries / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D013238:Stereotaxic Techniques; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed