gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Histopathological findings in intracerebral hemorrhage

Meeting Abstract

  • M. Holling - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
  • A. Jeibmann - Institut für Neuropathologie, Universitätsklinikum Münster, Münster
  • B.R. Fischer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
  • W. Stummer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
  • W. Paulus - Institut für Neuropathologie, Universitätsklinikum Münster, Münster

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.05.02

doi: 10.3205/11dgnc127, urn:nbn:de:0183-11dgnc1278

Published: April 28, 2011

© 2011 Holling et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Intracerebral hemorrhage is a common neurosurgical diagnosis and often leads to morbidity and mortality. Even though pathophysiological mechanisms seem to be well-known (i.e. hypertension and amyloidangiopathy), the importance of standardized neuropathologic examination of samples for the diagnosis and future therapy has not been evaluated in a larger series. The acquisition of tissue specimens for neuropathological examination following neurosurgery is still the basic approach to therapy.

Methods: From 1990 to 2010 a consecutive series of 378 surgical specimens of patients with intracerebral hemorrhage were evaluated in regard to patient characteristics, localization of hemorrhage, preoperative diagnosis and ultimate neuropathological diagnosis. Therapeutic relevance was defined as any histopathological diagnosis immediately affecting patient treatment. Cases with a history of trauma or the evidence of tumor or vascular malformations in CT / MR or known anticoagulant therapy in patient history were not included.

Results: Histological examination revealed a diagnosis with therapeutic relevance in 46 patients 12.2%, including vascular pathologies (78.3%), tumors (19.5%) and inflammatory processes (2.2%). The preoperative diagnosis could be confirmed in 17.3%. Aside from younger age (mean 62.79 years vs. 54.46 years; p = 0.001), no other features were associated with a higher risk of having a therapeutically relevant diagnosis in cases of underlying intracerebral bleeding.

Conclusions: Altogether, arteriosclerosis was seen in 15.6% of all cases examined, amyloidangiopathy in 10.1%, tumors in 2.4%. A therapeutically relevant diagnosis was identified in 12.2% and was significantly associated with a younger age. Therefore histological examination provides an efficient and inexpensive tool for detecting the underlying pathology.