Abstract

Introduction: Although intracerebral hemorrhage (ICH) is more common among African Americans, data on the burden of cerebral microbleeds (CMBs) among different racial populations is limited. The purpose of this study is to compare the number, associated factors, and topography of CMBs between African-American and white populations in the Mid-South United States. Methods: We reviewed consecutive patients who had magnetic resonance imaging (MRI) of brain at four tertiary centers in Memphis, Tennessee in a two-year period. T2*-weighted MRIs were assessed for the number, location, and topography of CMBs as well as other acute and chronic cerebrovascular diseases. We compared, by race, the baseline characteristics and clinical findings of patients with CMBs. Results: Out of 6,107 patients screened for this study, 176 (3%) patients (mean age: 63±15 years, 49% men, 77% African American, median CMB count: 8) had CMB on their brain imaging. There was a significant difference between African-American and white patients in terms of number of CMBs (16.5±18 vs. 6.5±5.5, p<001). There was no significant difference between two groups in terms of CMB location, gender, body mass index, history of head trauma as well as seizure, coronary artery, peripheral vascular, liver, and kidney disease. However, African-American group had a higher rate of clinical and silent stroke (92% vs. 71%, p=003), ICH (29% vs. 3%, p=.001), and severe leukoaraiosis (62% vs. 39%, p=.003). After adjusting for potential confounders, the African-American race was independently (p<0.014) associated with a higher CMB burden in multivariable logistic regression analyses. Conclusion: Our results suggest that African-American race might be independently associated with a higher CMB burden.

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