Surgical treatment of ICH caused by amyloid angiopathy remains controversial. Amyloid angiopathy almost never involves these structures. In contrast, HTN-related ICH frequently involves the basal ganglia and thalamic regions, the pons and the cerebellum. On one hand the location of the hematomas, affecting mainly the lobar superficial areas, a predominant involvement of the cortex and the frequent extension of blood into the subarachnoid space, and, on the other hand a lobulated or irregularly shaped appearance may suggest the diagnosis of CAA, especially if there are multiple hematomas. It is commonly felt that CAA-related ICH can be distinguished from HTN-related ICH by certain typical features on CT and MRI. To some extent, these features may contribute to distinguishing CAA from HTN related ICH.

Conclusion: There are certain features in CAA on CT and MRI and in clinical settings. Multiple hemorrhages, defined as 2 or more separate hematomas in multiple lobes, accounted for 17.1% in CAA-related ICH. More specifically, multiplicity of hemorrhage, bilaterality, and repeated episodes also strongly suggest the diagnosis of CAA. 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. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% 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. No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN.

There was a significantly higher number of hematomas≥30 ml in CAA (85.3%) when compared with HTN (59.5%). 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). 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. Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation.

Instal the new Zhan Lang 2