ABSTRACT
This chapter focuses on adult pathology and, therefore, does not cover topics such as sudden infant death syndrome or neonatal/infant ischaemic pathology. Non-traumatic parenchymal haemorrhages can be caused by a number of conditions, but by far the two commonest conditions are chronic hypertension and cerebral amyloid angiopathy (CAA). Chronic hypertension is common and contributes to significant morbidity and mortality in society. It is not only an important contributor to cognitive decline in ageing but also the most significant cause of primary parenchymal brain haemorrhage. Primary hypertensive haemorrhages are typically seen in the central white matter, involving basal ganglia and thalamic nuclei, cerebellum and pons. CAA refers to the abnormal deposition of ß-amyloid protein in the walls of small leptomeningeal and cortical arterioles. Hypoglycaemia produces a pattern of selective neuronal necrosis which, in its pure form, differs from that seen with ischaemia.
