The value of histopathological examination of surgically removed blood clot in determining the etiology of spontaneous intracerebral hemorrhage.

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Abstract
The surgical specimens from all evacuated spontaneous intracerebral and intracerebellar hemorrhages at the Toronto General Hospital from 1976 to 1981 were reviewed. Cases resulting from trauma or from pre-operatively diagnosed aneurysms or arteriovenous malformations were excluded, leaving 84 cases in which the etiology was unknown. Seventy-five of the cases were intracerebral hemorrhages, while 6 were intracerebellar and 3 were intraventricular. Brain tissue was received with the blood clot in 54 cases (64%). From this tissue, an anatomic diagnosis was made in 37 cases; and in 14, the specific etiology of the hemorrhage could be determined. The specific etiologic diagnoses were tumor (7), amyloid angiopathy (6) and abscess (1). In 4 other cases, vasculopathy associated with hypertension was suggested as a possible etiologic diagnosis. The high incidence of a specific etiologic diagnosis made from specimens in which tissue was included (25%) suggests that biopsy of adjacent brain tissue or preservation of tissue fragments identified at the time of surgery is of diagnostic value.