Spontaneous intracerebral hemorrhages - Neuropathological aspects

Non-traumatic so-called spontaneous intracerebral hemorrhages can occur in the supra- and infratentorial compartment. Taking into account their different etiologies, hemorrhages within the cerebral hemispheres are commonly divided into two categories, deep and lobar ones, with the first ones being frequently related to hypertensive vasculopathy. Lobar hemorrhages that are usually larger than their counterparts in the basal ganglia or thalamus, may be associated with arterio-venous malformations, leukemia or, especially in the elderly, with cerebral amyloid angiopathy (CAA) that is histopathologically characterized by deposits of beta A4-protein exclusively within the walls of medium-sized and small arteries of the leptomeninges and cerebral cortex.