Red meets white

Abstract

Cerebral microbleeds have captured the fascination of neurologists and clinical stroke researchers in particular. In the past decade, research focused on microbleeds has risen exponentially, providing important insights into the risk factors, pathophysiology, and neurologic consequences of these lesions. Microbleeds (detected on gradient echo or T2*-weighted MRI sequences) consist of hemosiderin accumulations that occur adjacent to small vessels that are indicative of extravasation of blood from prior small bleeds.1 Their significance for treatment decisions and patient management remains to be defined; nevertheless, it is clear that microbleeds have emerged as an important imaging marker of bleeding-prone microangiopathies and a possible contributor to vascular cognitive impairment.2 As such, microbleeds are potential target biomarkers for treatment interventions and risk factor control. Microbleeds are detected in 5% to 6% of the general elderly population, 30% of patients with ischemic stroke, and 60% of patients with primary intracerebral hemorrhage,3 numbers likely to grow with improving sensitivity of MRI.2 Hypertensive small vessel disease and cerebral amyloid angiopathy are the 2 most common …