Full Text:   <2591>

CLC number: R651.1

On-line Access: 

Received: 2004-01-04

Revision Accepted: 2004-03-24

Crosschecked: 0000-00-00

Cited: 16

Clicked: 5673

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE A 2004 Vol.5 No.10 P.1262-1269

http://doi.org/10.1631/jzus.2004.1262


Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage


Author(s):  ZHAN Ren-ya, TONG Ying, SHEN Jian-feng, LANG E., PREUL C., HEMPELMANN R.G., HUGO H.H., BUHL R., BARTH H., KLINGE H., MEHDORN H.M.

Affiliation(s):  Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; more

Corresponding email(s):   ZRY1960@hzcnc.com

Key Words:  Intracerebral hemorrhage, Cerebral amyloid angiopathy, Hypertension, Diagnosis, Computed tomography, Magnetic resonance imaging


Share this article to: More

ZHAN Ren-ya, TONG Ying, SHEN Jian-feng, LANG E., PREUL C., HEMPELMANN R.G., HUGO H.H., BUHL R., BARTH H., KLINGE H., MEHDORN H.M.. Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage[J]. Journal of Zhejiang University Science A, 2004, 5(10): 1262-1269.

@article{title="Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage",
author="ZHAN Ren-ya, TONG Ying, SHEN Jian-feng, LANG E., PREUL C., HEMPELMANN R.G., HUGO H.H., BUHL R., BARTH H., KLINGE H., MEHDORN H.M.",
journal="Journal of Zhejiang University Science A",
volume="5",
number="10",
pages="1262-1269",
year="2004",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2004.1262"
}

%0 Journal Article
%T Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage
%A ZHAN Ren-ya
%A TONG Ying
%A SHEN Jian-feng
%A LANG E.
%A PREUL C.
%A HEMPELMANN R.G.
%A HUGO H.H.
%A BUHL R.
%A BARTH H.
%A KLINGE H.
%A MEHDORN H.M.
%J Journal of Zhejiang University SCIENCE A
%V 5
%N 10
%P 1262-1269
%@ 1869-1951
%D 2004
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2004.1262

TY - JOUR
T1 - Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage
A1 - ZHAN Ren-ya
A1 - TONG Ying
A1 - SHEN Jian-feng
A1 - LANG E.
A1 - PREUL C.
A1 - HEMPELMANN R.G.
A1 - HUGO H.H.
A1 - BUHL R.
A1 - BARTH H.
A1 - KLINGE H.
A1 - MEHDORN H.M.
J0 - Journal of Zhejiang University Science A
VL - 5
IS - 10
SP - 1262
EP - 1269
%@ 1869-1951
Y1 - 2004
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2004.1262


Abstract: 
Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with histologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas≥30 ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, subarachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features of CAA-related ICH included lobar distribution affecting mainly the lobar superficial areas, lobulated appearance, rupture into the subarachnoid space, and secondary IVH from the lobar hemorrhage. More specifically, multiplicity of hemorrhage, bilaterality, and repeated episodes also strongly suggest the diagnosis of CAA. Multiple hemorrhages, defined as 2 or more separate hematomas in multiple lobes, accounted for 17.1% in CAA-related ICH. Conclusion: There are certain features in CAA on CT and MRI and in clinical settings. To some extent, these features may contribute to distinguishing CAA from HTN related ICH.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1] Awasthi, D., Voorhies, R.M., Eick, J., Mitchell, W.T., 1991. Cerebral amyloid angiopathy presenting as multiple intracranial lesions on magnetic resonance imaging: case report. J Neurosurg, 75(3):458-460.

[2] Behl, C., Davis, J.B., Lesley, R., Schubert, D., 1994. Hydrogen peroxide mediates amyloid beta-protein toxicity. Cell, 77(6):817-827.

[3] Broderick, J., Brott, T., Tomsik, L., Leach, A., 1993. Lobar hemorrhage in the elderly: The undiminishing importance of hypertension. Stroke, 24(1):49-51.

[4] Cuny, E., Loiseau, H., Rivel, J., Vital, C., Castel, J.P., 1996. Amyloid angiopathy-related cerebellar hemorrhage. Surg Neurol, 46(3):235-239.

[5] Hendricks, H.T., Franke, E.L., Theunissen, P.H., 1990. Cerebral amyloid angiopathy: Diagnosis by MRI and brain biopsy. Neurology, 40(8):1308-1310.

[6] Itoh, Y., Yamada, M., 1997. Cerebral amyloid angiopathy in the elderly: the clinicopathological features, pathogenesis, and risk factors. J Med Dent Sci, 44(1):11-19.

[7] Izumihara, A., Ishihara, T., Iwamoto, N., Yamashita, K., Ito, H., 1999. Postoperative outcome of 37 patients with lobar intracerebral hemorrhage related to cerebral amyloid angiopathy. Stroke, 30(1):29-33.

[8] Kase, C., 1991. Diagnosis and management of intracerebral hemorrhage in elderly patients. Clin Ger Med, 7(3):549-567.

[9] Lang, E.W., Zhan, R.Y., Preul, C., Hugo, H.H., Hempelmann, R.G., Buhl, R., Barth, H., Klinge, H., Mehdorn, H.M., 2001. Stroke pattern interpretation: The variability of hypertensive versus amyloid angiopathy hemorrhage. Cerebrovascular Diseases, 12(2):121-130.

[10] Leblanc, R., Preul, M., Robitaille, Y., Villemure, J.G., Pokrupa, R., 1991. Surgical consideration in cerebral amyloid angiopathy. Neurosurg, 29(5):712-718.

[11] Minakawa, T., Takeuchi, S., Sasaki, O., Koizumi, T., Honad, Y., Fujii, Y., Ozawa, T., Ogawa, H., Koike, T., Tanaka, R., 1995. Surgical experience with massive lobar hemorrhage caused by cerebral amyloid angiopathy. Acta Neurochir (wein), 132(1-3):48-52.

[12] Neau, J.P., Ingrand, P., Couderq, C., Rosier, M.P., Bailbe, M., Dumas, P., Vandermarcq, P., Gil, R., 1997. Recurrent intracerebral hemorrhage. Neurology, 49(1):106-113.

[13] Passero, S., Burgalassi, L., D’Andrea, P., Battistini, N., 1995. Recurrence of bleeding in patients with primary intracerebral hemorrhage. Stroke, 26(7):1189-1192.

[14] Ramsay, D.A., Penswick, J.L., Robertson, D.M., 1990. Fatal streptokinase-induced intracerebral hemorrhage in cerebral amyloid angiopathy. Can J Neurol Sci, 17(3):336-341.

[15] Thomas, T., Thomas, G., MeLendon, C., Sutton, T., Mullan, M., 1996. Beta-amyloid-mediated vasoactivity and vascular endothelial damage. Nature, 380(6570):168-171.

[16] Vonsattel, J.P., Myers, R.H., Hedley-Whyte, E.T., Ropper, A.H., Bird, E.D., Richardson, E.P., 1991. Cerebral amyloid angiopathy without and with cerebral hemorrhages: a comparative histological study. Ann Neurol, 30(5):637-639.

[17] Wakai, S., Kumakura, N., Nagai, M., 1992. Lobar intracerebral hemorrhage: A clinical, radiographic, and pathological study of 29 consecutively operated cases with negative angiography. J Neurosurg, 76(2):231-238.

[18] Yamada, M., Itoh, Y., Otomo, E., Hayakawa, M., Miyatake, T., 1993. Subarachnoid hemorrhage in the elderly:a necropsy study of the association with cerebral amyloid angiopathy. J Neurol Neurosurg Psychiatry, 56(5):543-547.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2022 Journal of Zhejiang University-SCIENCE