title: Angiogenesis in steno-occlusive vasculopathies as a common pathway for intracranial haemorrhage. A report of six cases.
abstract: Vasculopathies, including vasculitis of the central nervous system, can lead to stenosed, cicatrized vessels and the development of arterio-arteriolar collateral vessels. Bleeding due to these vascular changes, although rare, does occur. We describe six patients (all female, age range, 21-52 years; mean age, 42 years) with steno-occlusive lesions of intracranial vessels who presented with an acute intracranial haemorrhage. All had arterial steno-occlusive changes in conjunction with extensive leptomeningeal and arterio-arteriolar collaterals. Within the collaterals, focal dilatations could be identified, which were in close spatial relationship with the intracranial haemorrhage. Cause of bleeding was depicted on CT angiography in four out of six patients. One patient presented in childhood with acute stroke, one patient was diagnosed with Buerger's disease and one with sickle cell disease; the other three patients had no relevant history and the exact cause remained unclear. Outcome was favourable in all patients. Despite focal vascular weaknesses, no recurrent haemorrhage was seen during follow-up, supporting, at least in this small patient group, a conservative wait-and-see policy.
authors.affiliation: Department of Radiology, Academic Medical Centre, University of Amsterdam; Amsterdam, The Netherlands - R.vdberg@amc.uva.nl.
authors.forename: René
authors.initials: R
authors.lastname: van den Berg
authors.affiliation: Department of Neurosurgery, Radboud University Medical Centre; Nijmegen, The Netherlands.
authors.forename: Astrid L
authors.initials: AL
authors.lastname: Rijssenbeek
authors.affiliation: Department of Radiology, Academic Medical Centre, University of Amsterdam; Amsterdam, The Netherlands.
authors.forename: Marieke E S
authors.initials: ME
authors.lastname: Sprengers
authors.affiliation: Department of Radiology, VU Medical Centre; Amsterdam, The Netherlands.
authors.forename: Joost C J
authors.initials: JC
authors.lastname: Bot
authors.affiliation: Department of Radiology, Academic Medical Centre, University of Amsterdam; Amsterdam, The Netherlands.
authors.forename: Charles B L M
authors.initials: CB
authors.lastname: Majoie
authors.affiliation: Department of Neurology, Academic Medical Centre, University of Amsterdam; Amsterdam, The Netherlands.
authors.forename: Yvo B W E M
authors.initials: YB
authors.lastname: Roos
authors.affiliation: Neurosurgical Centre Amsterdam, Academic Medical Centre, University of Amsterdam; Amsterdam, The Netherlands.
authors.forename: William P
authors.initials: WP
authors.lastname: Vandertop
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D055815:Young Adult
keywords: angiography; angiopathy; intracranial haemorrhage