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Surgery for cerebral amyloid angiopathy-related hemorrhage.

To the Editor: 

The report by Izumihara et al1 adds to an existing body of evidence2 3 that neurosurgery does not have a significant adverse influence on outcome from cerebral amyloid angiopathy–related hemorrhage (CAAH). Although surgery for CAAH appears to be relatively safe, its effectiveness as in intracerebral hemorrhage in general4 remains controversial.

The authors identified 3 clinical factors (patients aged over 75 years, a parietal hematoma, and intraventricular hemorrhage) that had an adverse effect on postoperative outcome. However, Glasgow Coma Scale score, which has been shown to be one of the most powerful determinants of outcome in intracerebral hemorrhage,5 6 was unfortunately not included in this analysis. This is an important clinical factor, …