More
About Lobar Hemorrhage
It has
recently been recognized that small arteries supplying the superficial regions
of the cerebral hemispheres may develop deposits of an abnormal protein called
amyloid in the extremely elderly. In some cases, this material can weaken
the walls of these vessels to the extent that they rupture and cause hemorrhages
in the superficial regions of the hemispheres. These are termed lobar
hemorrhages (presumably because they involve outer portions of the various lobes
of the brain). Unlike the intracerebral hemorrhages involving midline
penetrating vessels, superficial lobar hemorrhages can occur in individuals
who have had normal blood pressure throughout their lives.
Case
of RK
R.K. is an 84 year-old woman who has had normal blood pressure all her life.
She suddenly developed a headache, and paralysis
of her left arm and leg. She died 24 hours later.
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This
is R.K.'s brain. Locate the hemorrhages.
Notice that the hemorrhage is primarily located in the right frontal
lobe.
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This
is a vessel near the hemorrhage. Its wall is thick, and irregular,
and it shows an unusual red coloration in this hematoxylin and eosin
stained section. This material has been identified by immunohistochemistry
as beta-amyloid. Click here to see vessels from R.K.s brain stained
for this abnormal protein.
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Can
you see the red stained areas which indicate the presence of beta-amyloid
in the walls of the vessels?
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