Cerebral amyloid angiopathy causing large contralateral hemorrhage during surgery for lobar hemorrhage: a case report
Cerebral amyloid angiopathy causing large contralateral hemorrhage during surgery for lobar hemorrhage: a case report
复制标题
脑淀粉样血管病导致脑叶出血手术期间对侧大出血：一例报告
DOI：
10.1016/j.jstrokecerebrovasdis.2014.11.015
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Kikuta K
中科院分区：
文献类型：
--
作者：
Arishima H;Neishi H;Kodera T;Kitai R;Kikuta K
我们报告一例罕见的脑淀粉样血管病（CAA）在脑叶出血手术中引起对侧大出血。一位62岁的女性，在过去的1个月里，左侧额叶和顶叶反复出现脑叶出血。由于我们无法检测到脑叶出血的起源，我们在脑叶出血部位周围进行了活检并清除了血肿。在手术过程中，我们发现急性脑肿胀，没有出血的手术领域。术中计算机断层扫描显示右侧顶叶新发大出血，我们可以及时切除。两侧血肿周围标本经免疫组化检查病理诊断为CAA。手术后，她在短短3个月的时间内发生了3次脑叶出血。据我们所知，目前还没有CAA在手术过程中导致其他病变颅内出血的报告。神经外科医生应了解CAA引起脑叶出血的术中出血可能性。
We report a rare case of cerebral amyloid angiopathy (CAA) causing large contralateral hemorrhage during surgery for lobar hemorrhage. A 62-year-old woman presented with lobar hemorrhage in the left frontal and parietal lobes recurring over the previous 1 month. Because we could not detect the origin of the lobar hemorrhage, we performed a biopsy around the lobar hemorrhage site with the removal of a hematoma. During the surgery, we identified acute brain swelling without bleeding from the operative field. Intraoperative computed tomography demonstrated new large lobar hemorrhage of the right parietal lobe, which we could promptly remove. Specimens around hematomas on both sides were pathologically diagnosed as CAA on immunohistochemical examination. After the surgery, she suffered from lobar hemorrhage three times in the space of only 3 months. To the best of our knowledge, there has been no reported case of CAA causing intracranial hemorrhage of another lesion during surgery. Neurosurgeons should know a possibility of intraoperative hemorrhage in surgeries for lobar hemorrhage caused by CAA.