110

Document Type

Article

Abstract

OBJECTIVE: To evaluate the clinical and histopathological features of elderly patients with subcortical intracerebral hemorrhage (ICH), and to analyze the presence of cerebral amyloid angiopathy (CAA) and Alzheimer's disease (AD) type pathologic changes using amyloid beta (Aβ) and tau immunohistochemistry. PATIENTS AND METHODS: We retrospectively analyzed cases satisfying the Boston criteria for CAA among patients with subcortical hemorrhage who underwent surgical removal by craniotomy at our hospital. Surgical specimens were subjected to hematoxylin and eosin (HE) staining as well as immunostaining. RESULTS: A total of 54 patients were included in this study, with a mean age of 74.5 years (range: 72.5-76.5 years, 95% confidence interval [CI]; 51% female). Of these 54 patients, 31 (57%) were hypertensive, 18 (33%) were undergoing antithrombotic therapy, and 12 (22%) had dementia. Strong immunoreactivity for Aβ40 in the cerebral vessels was observed in 30 patients (55.6%), and among these, 27 patients (90%) also showed strong immunoreactivity for Aβ42. Among the 54 patients, 25 (46%) exhibited AD characteristics, including Aβ-positive senile plaques and AT8-positive neurons. Multivariate analysis revealed that strong Aβ40 immunoreactivity in the cerebral vessels was associated with older patients, females, lack of high blood pressure, and the presence of AT8-positive neurons. CONCLUSION: CAA patients with strong Aβ40 deposition in the cerebral vessels were associated with subcortical hemorrhage in our cohort. Future studies should investigate the pathomechanism of ICH in individuals with CAA.

Keywords

Amyloid beta, Cerebral amyloid angiopathy, Intracerebral hemorrhage

Medical Subject Headings

Aged; Alzheimer Disease (pathology); Amyloid beta-Peptides (metabolism); Cerebral Amyloid Angiopathy (complications, pathology); Cerebral Hemorrhage (pathology, surgery); Craniotomy (methods); Female; Humans; Hypertension (complications); Male; Nervous System Diseases (pathology, surgery); Retrospective Studies

Publication Date

1-1-2019

Publication Title

Clinical neurology and neurosurgery

E-ISSN

1872-6968

Volume

176

Last Page

115

PubMed ID

30554091

Digital Object Identifier (DOI)

10.1016/j.clineuro.2018.11.020

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