title: Clinico-Radiological Characteristics and Pathological Diagnosis of Cerebral Amyloid Angiopathy-Related Intracerebral Hemorrhage.
abstract: OBJECTIVE
  We aim to clarify the clinico-radiological characteristics of cerebral amyloid angiopathy-related intracerebral hemorrhage and to investigate the efficacy of pathological diagnosis using biopsy specimens.
  
  
  METHODS
  We retrospectively reviewed 253 consecutive patients with cortico-subcortical hemorrhage who had been admitted to Aizawa Hospital between January 2006 and July 2013. We had performed craniotomy and hematoma evacuation in 48 patients, as well as biopsy of the evacuated hematoma, cerebral parenchyma adjacent to the hematoma, or both, and they were classified according to the histological results (positive or negative for vascular amyloid deposition) and to the Boston criteria. We compared the clinico-radiological characteristics of cerebral amyloid angiopathy-related intracerebral hemorrhage. We also investigated the detection rate of cerebral amyloid angiopathy with respect to the origins of the specimens.
  
  
  RESULTS
  Pathological examination revealed that 22 subjects were positive for vascular amyloid. The number of the cerebral microbleeds located in the deep or infratentorial region was significantly larger in the negative group than in the positive group (P <.05). There was no significant difference in the distribution of lobar cerebral microbleeds and in the prevalence of hypertension. In the probable cerebral amyloid angiopathy-related intracerebral hemorrhage patients, the probability of having vascular amyloid detected by biopsy of both hematoma and parenchyma was 100%. Rebleeding in the postoperative periods was observed in 2 cases (9.1%) of the positive group.
  
  
  CONCLUSIONS
  Our results demonstrate the importance and safety of biopsy simultaneously performed with hematoma evacuation. Deep or infratentorial microbleeds are less correlated with cerebral amyloid angiopathy-related intracerebral hemorrhage than with noncerebral amyloid angiopathy-related intracerebral hemorrhage.
authors.affiliation: Department of Neurology, Aizawa Hospital, Matsumoto, Japan; Brain Imaging Research Center, Aizawa Hospital, Matsumoto, Japan; Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: aidr214@ai-hosp.or.jp.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Doden
authors.affiliation: Department of Neurology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Sato
authors.affiliation: Department of Neurology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Sasahara
authors.affiliation: Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Murata
authors.affiliation: Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yako
authors.affiliation: Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitazawa
authors.affiliation: Department of Anatomic Pathology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Higuchi
authors.affiliation: Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Neurology, Aizawa Hospital, Matsumoto, Japan; Brain Imaging Research Center, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001923:Brain Chemistry; D016657:Cerebral Amyloid Angiopathy / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002536:Cerebral Arteries / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D003399:Craniotomy; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000072356:Parenchymal Tissue / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers
keywords: Cerebral amyloid angiopathy; biopsy; cerebral microbleeds; diagnosis; intracerebral hemorrhage