THE RISK OF CEREBRAL MICROBLEEDS IN ISCHEMIC STROKE PATIENTS USING ANTIPLATELET THERAPIES

Abstract

Background: Interest in cerebral microbleeds (CMBs) has increased based on advances in magnetic resonance imaging (MRI) technology. Both MRI T2-weighted gradient-echo (GRE) and susceptibility-weighted imaging may be sensitive techniques for the detection of past and more recent brain hemorrhage. The prevalence of CMBs in healthy population ranges 3.7–7.7%, whereas in patients with intracerebral hemorrhage is thought to be around 60%.Objective: To evaluate the prevalence and possible risk of microbleeds among patients with ischemic stroke using antiplatelets (Aps).Patients and Methods: The observational hospital-based cross-sectional analytical study involved 150 consecutive patients with ischemic stroke (recent or old ischemic strokes or both), from inpatients of neurology departments of Ain Shams University Hospital and Agouza Police Hospital for a period of 15 months from April 2018 to June 2019.Results: Cerebral microbleeds were present in 13 patients representing 26% of the no AP group, 16 patients representing 32% of the single AP group and 19 patients representing 38% of the double AP group, there was no statistically significant difference between the three groups of patients. Cerebral microbleeds were present in 60% of patients on double APs and 37.5% of patient on single AP for more than two years, compared to 23.3%and 26.9%for the two groups respectively on APs for less than two years, In the current study we found that the significant risk factor for the presence of CMBs was the duration of APs use. There was no statistically significant difference in the laboratory data (including full lipid profile, HbA1c and platelet count) between the three groups.Conclusion: CMBs are significantly associated with long term use of antiplatelets, so careful clinical and radiological follow up of ischemic stroke patients with CMBs using antiplatelets for risk of future intracranial hemorrhage.