Pathological examination of cerebral amyloid angiopathy in patients who underwent removal of lobar hemorrhages

Chien Min Lin, Hidetaka Arishima, Ken ichiro Kikuta, Hironobu Naiki, Ryuhei Kitai, Toshiaki Kodera, Ken Matsuda, Norichika Hashimoto, Makoto Isozaki, Kenzo Tsunetoshi, Hiroyuki Neishi, Yoshifumi Higashino, Ayumi Akazawa, Hiroshi Arai, Shinsuke Yamada

研究成果: 雜誌貢獻文章同行評審

6 引文 斯高帕斯(Scopus)

摘要

Cerebral amyloid angiopathy (CAA) is a degenerative disorder characterized by amyloid-β (Aβ) deposition in the brain microvessels. CAA is also known to contribute not only to cortical microbleeds but also lobar hemorrhages. This retrospective study examined CAA pathologically in patients who underwent direct surgeries for lobar hemorrhage. Thirty-three patients with lobar hemorrhage underwent open surgery with biopsy from 2007 to 2016 in our hospital. Cortical tissues over hematomas obtained surgically were pathologically examined using hematoxylin, eosin stain, and anti-Aβ antibody to diagnose CAA. We also investigated the advanced degree of CAA and clinical features of each patient with lobar hemorrhage. In the 33 patients, 4 yielded specimens that were insufficient to evaluate CAA pathologically. Twenty-four of the remaining 29 patients (82.8%) were pathologically diagnosed with CAA. The majority of CAA-positive patients had moderate or severe CAA based on a grading scale to estimate the advanced degree of CAA. About half of the CAA-positive patients had hypertension, and four took anticoagulant or antiplatelet agents. In five patients who were not pathologically diagnosed with CAA, one had severe liver function disorder, three had uncontrollable hypertension, and one had no obvious risk factor. Our pathological findings suggest that severe CAA with vasculopathic change markedly contributes to lobar hemorrhage. The coexistence of severe CAA and risk factors such as hypertension, anticoagulants or antiplatelets may readily induce lobar hemorrhage.

原文英語
頁(從 - 到)567-577
頁數11
期刊Journal of Neurology
265
發行號3
DOIs
出版狀態已發佈 - 三月 1 2018

ASJC Scopus subject areas

  • 神經內科
  • 神經病學(臨床)

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