Cerebral amyloid angiopathy as a cause of multiple intracerebral hemorrhages.

Clinical and pathologic findings in six autopsies and five biopsies of cerebral amyloid angiopathy associated with cerebromeningeal hemorrhages are presented. One patient had experienced a previous meningeal hemorrhage. Only two had chronic hypertension; the multiple fresh hematomas found in all the autopsied brains always spared the basal ganglia and brainstem, as did vascular lesions, which were mostly cortical and meningeal. Extensive lesions of Alzheimer's disease were found in the autopsied cases with dementia. The most significant feature for clinical diagnosis of hemorrhagic cerebral amyloid angiopathy is the presence of multiple hemorrhages in unusual locations in the absence of hypertension.