This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Izumihara, A. Articles by Ito, H. Search for Related Content PubMed PubMed Citation Articles by Izumihara, A. Articles by Ito, H. Pubmed/NCBI databases Medline Plus Health Information Amyloidosis Related Collections Health policy and outcome research Acute Cerebral Hemorrhage Other Stroke Treatment - Surgical

(Stroke. 1999;30:29-33.)
© 1999 American Heart Association, Inc.

Original Contributions

Postoperative Outcome of 37 Patients With Lobar Intracerebral Hemorrhage Related to Cerebral Amyloid Angiopathy

Akifumi Izumihara, MD; Tokuhiro Ishihara, MD; Naoki Iwamoto, MD; Katsuhiro Yamashita, MD Haruhide Ito, MD

From the Department of Neurosurgery (A.I., N.I., K.Y., H.I.) and the First Department of Pathology (T.I.), Yamaguchi University School of Medicine, Yamaguchi, Japan.

Correspondence to Akifumi Izumihara, MD, Department of Neurosurgery, Yamaguchi University School of Medicine, 1144 Kogushi, Ube, Yamaguchi 755-8505, Japan. E-mail yamasita-ygc{at}umin.u-tokyo.ac.jp

Background and Purpose—Several recent studies have suggested that neurosurgical procedures are not contraindicated in patients with cerebral amyloid angiopathy (CAA). The purpose of this study was to elucidate the clinical factors influencing the outcome of patients with CAA-related intracerebral hemorrhage (ICH) treated surgically.

Methods—A total of 50 neurosurgical procedures (42 intracerebral hematoma evacuations, 4 ventriculoperitoneal shunts, 3 ventricular drainages, and 1 brain biopsy) were performed in 37 patients with CAA-related ICH. To ascertain the clinical factors that may influence their postoperative outcome, their clinical data (demographics, medical history, recurrent lobar hemorrhage, radiographic characteristics, multiple lobar hemorrhage, surgical details, and postoperative hemorrhage) were examined retrospectively and subjected to multivariate analysis.

Results—Twenty patients (54%) had a good outcome, and only 4 (11%) died. Parietal hematomas, advanced age (75 years), and intraventricular hemorrhages had significant adverse influence on the postoperative outcome. Clinically significant postoperative hemorrhage requiring evacuation occurred after 2 (5%) of 42 intracerebral hematoma evacuations. Postoperative hemorrhage did not have significant adverse influence on the outcome.

Conclusions—Neurosurgery can be performed relatively safely in patients with CAA-related ICH, and their postoperative outcome is better than that reported previously. Surgical treatment should be considered for such patients aged <75 years without a parietal hematoma and intraventricular hemorrhage.

Key Words: amyloid • intracerebral hemorrhage • outcome

This article has been cited by other articles:

				B. Thanvi and T. Robinson Sporadic cerebral amyloid angiopathy--an important cause of cerebral haemorrhage in older people Age Ageing, November 1, 2006; 35(6): 565 - 571. [Abstract] [Full Text] [PDF]

				C. P. Chao, A. L. Kotsenas, and D. F. Broderick Cerebral Amyloid Angiopathy: CT and MR Imaging Findings RadioGraphics, September 1, 2006; 26(5): 1517 - 1531. [Abstract] [Full Text] [PDF]

				M. O. McCarron, J. A. R. Nicoll, J. W. Ironside, S. Love, M. J. Alberts, and I. Bone Cerebral Amyloid Angiopathy–Related Hemorrhage : Interaction of APOE {epsilon}2 With Putative Clinical Risk Factors Stroke, August 1, 1999; 30(8): 1643 - 1646. [Abstract] [Full Text] [PDF]

				M. O. McCarron, J. A.R. Nicoll, A. Izumihara, N. Iwamoto, K. Yamashita, H. Ito, and T. Ishihara Surgery for Cerebral Amyloid Angiopathy–Related Hemorrhage • Response Stroke, June 1, 1999; 30(6): 1291 - 1291. [Full Text] [PDF]