CEREBRAL AMYLOID ANGIOPATHY - A SIGNIFICANT CAUSE OF CEREBELLAR AS WELL AS LOBAR CEREBRAL-HEMORRHAGE IN THE ELDERLY

We investigated consecutive 1000 autopsied cases (average age 82.9 yea rs) clinicopathologically in order to reveal the significance of cereb ral amyloid angiopathy (CAA) as a cause of senile intracranial hemorrh ages. We found 101 cases with intracerebral hemorrhages, and CAA accou nted for 10.9% of them (31.0% of lobar cerebral hemorrhages, and 14.3% of cerebellar ones). In contrast to hypertensive hemorrhages, CAA-rel ated ones (1) ruptured into the subarachnoid space without exception, (2) often coexisted with dementia of Alzheimer's type, and (3) frequen tly occurred in the night without elevated blood pressure at onset. Th e cerebrovascular amyloid was strongly immunoreactive with antibody to beta-protein in all of the cases with CAA-related hemorrhages, and le ss intensively with antibody to cystatin C in 91% of them. Our data in dicate that CAA is an important etiological factor of cerebellar hemor rhages, as well as lobar cerebral hemorrhages, in normotensive, aged p atients.