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Cerebral amyloid angiopathy and cerebral hemorrhage:Where is the origin of the hemorrhage? Shigeki Takeda 1 , Kiyoshi Onda 2 , Hiroyuki Arai 2 , Fusahiro Ikuta 3 1Department of Pathology, Niigata Neurosurgical Hospital and Brain Reserch Center 2Department of Neurosurgery, Niigata Neurosurgical Hospital 3Department of Brain Reserch Center, Niigata Neurosurgical Hospital Keyword: 脳アミロイド・アンギオパチー , 皮質下出血 , くも膜下出血 pp.467-474
Published Date 2004/6/10
DOI https://doi.org/10.11477/mf.1431100275
  • Abstract
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 The subcortical hemorrhages in cerebral amyloid angiopathy(CAA)has been said to originate from the rupture of the cortical vessels which are infiltrated with amyloid. CAA-related hemorrhage frequently occures subarachnoid hemorrhage, which is said to the secondary evidence. Recently, we have studied six autopsied cases associated with CAA-related hemorrhages and obtained the findings as follows;1)all of our examined cases had multiple hematomas in the subarachnoid space, mainly in the cerebral sulci, as well as intracerebral hematomas, 2)each intracerebral hematoma was connected to the subarachnoid hematomas at the depth of cerebral sulci or through the lateral side of the cortex, 3)in one case, another solitary subarachnoid hematoma, which was not connected to any intracerebral hematoma, was seen, 4)in all of these subarachnoid hematomas, many ruptured amyloid-infiltrated arteries up to 300μm in diameter were observed, and 5)there were no ruptured vessels within the intracerebral hematomas. Our study indicates that in some cases of CAA-related hemorrhage origenates from the rupture of the meningeal vessels, particular in the cerebral sulci. Infarction occurs subsequently in the cortex around the subarachnoid hematoma, the hematoma penetrates into the brain parenchyma, and finally, a subcortical hematoma is formed.


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電子版ISSN 1882-1243 印刷版ISSN 0001-8724 医学書院

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