Cerebral amyloid angiopathy: incidence and complications in the aging brain. I. Cerebral hemorrhage.

Abstract

The clinical and pathologic findings in 11 patients with fatal cerebral hemorrhages related to cerebral amyloid angiopathy (CAA) are described. The hemorrhages were bihemispheric, though not necessarily of simultaneous onset in 4 patients, and favored the fronto-parietal cortex and white matter in 10 patients. Dissection into the subarachnoid space was common. Cerebrovascular lesions or cardiomegaly related to hypertension coexisted with those of CAA in 3 cases. Seven patients were not demented prior to the ictus. Ten of 11 brains contained abundant sensile plaques and/or neurofibrillary tangles, whether or not the patient was clinically demented. In the elderly, CAA is an important etiologic consideration for cerebral hemorrhage, especially if the hemorrhage occurs in a peripheral location in the brain and is superimposed on a history of dementia.