Severity Of Cerebral Microbleeds Research Articles

Correlation between Cerebral Microbleeds and White Matter Changes on MRI using Microbleed Anatomical Rating and Fazekas Scales: A Cross-sectional Study

Introduction: Cerebral Microbleeds (CMBs) are small perivascular haemosiderin deposits in the brain that indicate bleeding events. The location of CMBs can provide insights into their underlying causes. CMBs found in peripheral lobar locations are often associated with cerebral amyloid angiopathy, while those occurring in deeper brain regions are more likely linked to hypertensive arteriopathy. White matter changes, known as Leukoaraiosis, have been linked to adverse cognitive functions, share risk factors with hypertension and microbleeds, and are associated with the severity of CMBs. Aim: To determine the correlation between CMBs and white matter changes on Magnetic Resonance Imagning (MRI) using the Microbleed Anatomical Rating Scale (MARS) and Fazekas scales. Materials and Methods: An analytical cross-sectional study was conducted in the Department of Radiodiagnosis, MS Ramaiah Hospitals, Bengaluru, Karnataka, India between November 2019 and June 2021, involving 65 subjects who underwent MRI brain scans at a tertiary care institute and were found to have microbleeds. Brain MRIs were performed using a 1.5 Tesla MRI Scanning Unit. Microbleeds were graded using the MARS, while white matter changes were graded using the Fazekas scale. The Chi-square test was employed to assess the significance of categorical data, and Spearman’s correlation was used to determine the correlation between MARS and Fazekas scale variables. Results: The subjects had a mean age range of 61 to 70 years, with a male-to-female ratio of 2:1. There was a significant correlation between MARS grade and Fazekas scale (p<0.001) with a correlation coefficient (r-value) of 1. The most commonly associated stroke subtype was lacunar infarct. Conclusion: There is a significant correlation between Leukoaraiosis (LA) and CMBs, indicating the end results of small vessel ischaemia and bleeding.

Artificial intelligence‐driven algorithm to detect and count cerebral microbleeds on Susceptibility Weighted Imaging

AbstractBackgroundAmyloid‐related imaging abnormalities (ARIA)‐H, characterized by cerebral microbleeds (CMB) and superficial siderosis, is an important Magnetic Resonance Imaging(MRI) finding observed in the patients with Alzheimer’s disease, especially receiving the anti‐amyloid immunotherapy. Because the severity of CMB can potentially lead to discontinuation of the therapy, the detection and counting of the CMB would be critical tasks in MRI analysis. We present an algorithm which can detect CMBs and count the number of them, automatically and accurately.MethodWe employed datasets of both SWI and phase images, developed in collaboration with Eunpyeong St. Mary’s Hospital, Kyung Hee, and HanYang University Medical Center. The data set comprises 463 participants with CMBs (N = 247) and without CMBs (N = 116). Experts denoted gold standard of each CMBs as bounding boxes. A localizer is trained by selecting 2D axial slices, including expert‐confirmed annotations. A modified recurrent layer was applied for weight‐sharing between two images. An optimized region proposal network was then applied. To reduce FP regions across entire slices, we developed a classifier with attention‐based 3D convolution blocks. From the CMB localizer, candidate 3D CMB patches were used in the classifier.ResultCMB prediction was performed on the test set including 140 participants (CMB:24; Non‐CMB:116), with 263 expert‐confirmed gold standard (Figure 1). The lesion‐wise sensitivity was 0.913 [95% Confidence interval (CI), 0.863‐0.963] and the average FP rate was 0.672 per patient [95% CI, 0.290‐1.154]. Patient‐wise sensitivity and specificity were 0.862 [95% CI, 0.792‐0.932] and 0.907 [95% CI, 0.880‐0.934], respectively. When we divided the patients into four groups according to the number of gold standard, the model predicted the groups correctly by the sensitivity of 0.879 [95% CI, 0.851‐0.907] (Table 1).ConclusionOur model outperformed the results of recent studies by reducing FP rate with comparable sensitivity. Moreover, our model may suggest additional clinical benefit, because it can automatically count the number of CMB and classify the participants into 4 groups, used in the clinical investigation of anti‐amyloid therapy, according to the number of CMB. We expect this model may improve the workflow of the time‐consuming reading task and act as a failsafe for the detection of CMBs.

The correlation between the severity of cerebral microbleeds and serum HMGB1 levels and cognitive impairment in patients with cerebral small vessel disease.

The study investigated the correlation and predictive value between the severity of cerebral microbleeds (CMBs) and the level of serum High Mobility Group Protein B1 (HMGB1) and the occurrence of cognitive impairment in patients with cerebral small vessel disease (CSVD). A total of 139 patients with CSVD admitted to the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from December 2020 to December 2022 were selected as study subjects. The Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function and was divided into the cognitive impairment group and the cognitive normal group. Magnetic Resonance Imaging (MRI) and Susceptibility Weighted Imaging (SWI) were used to screen and assess the severity of CMBs. Serum HMGB1 levels of CSVD patients were measured by enzyme linked immunosorbent assay (ELISA). Multivariable logistic regression analysis was used to explore risk factors for cognitive impairment and CMBs. Pearson correlation analysis was used to investigate the correlation between HMGB1 and cognitive function. Receiver Operating Characteristics (ROC) curves were used to assess the predictive value of HMGB1 for the occurrence of cognitive impairment in patients with CMBs. High Mobility Group Protein B1, uric acid (UA), glycosylated hemoglobin (HbA1c), CMBs, lacunar cerebral infarction (LI), years of education, and history of hypertension were risk factors for cognitive impairment (P < 0.05); HMGB1 was significantly and negatively associated with total MoCA score, visuospatial/executive ability, and delayed recall ability (P < 0.05). HMGB1 was significantly and positively correlated with the number of CMBs (P < 0.05). The area under the ROC curve for HMGB1 predicting cognitive impairment in patients with CMBs was 0.807 (P < 0.001). Serum HMGB1 levels are associated with the development of cognitive impairment in CSVD patients, and serum HMGB1 levels have a high predictive value for the development of cognitive impairment in CSVD patients with combined CMBs, which can be used for early clinical identification and intervention of vascular cognitive impairment.

Gender heterogeneity in the influencing factors for cerebral microbleeds in acute ischemic stroke patients

Background Cerebral microbleeds (CMBs) are common in acute ischemic stroke (AIS) patients. The presence of CMBs increases the risk of hemorrhagic transformation in AIS patients, and it is also closely associated with cognitive decline and even dementia. At present, there exist different opinions on the independent risk factors for CMBs, and there is no consensus on whether there are gender differences in -post-stroke CMB. Therefore, this study sought to investigate gender heterogeneity in the influencing factors for CMBs by studying male and female AIS patients. Methods This was a China-based, Single-center, retrospective review of data from 482 AIS inpatients at the Neurology Department of Hebei General Hospital (NCT05882123). Both demographic and clinical data were collected from the study subjects. Different head magnetic resonance imaging sequences were used to assess the subjects’ CMBs, white matter lesions, and old lacunar infarcts (LI). Various statistical methods, including the t-test, χ 2 test, and logistic regression, were used to analyze the gender heterogeneity of the influencing factors for CMBs in AIS patients. Results When compared with the male AIS patients, the female AIS patients were older and had higher total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, ApoA, ApoB, and fibrinogen levels. The female AIS patients also had higher National Institute of Health Stroke Scale scores and hypertension disease composition ratios. By contrast, the proportions of female AIS patients with a history of smoking and a history of alcohol consumption were both lower than the corresponding proportions of male AIS patients. These differences were all statistically significant (p < .05). There were no statistically significant differences in the incidence and severity of CMBs between the male and female AIS patients (χ 2 ＝ 0.851, 3.092, p > .05). The univariate and multivariate stepwise logistic regression analyses confirmed that age (OR = 1.074, 95% CI: 1.013–1.139, p = .016) and old LI (OR = 4.295, 95% CI: 1.062–17.375, p = .041) were independent risk factors for comorbid CMBs in the female AIS patients, while blood glucose (OR = 0.692, 95% CI: 0.494–0.968, p = .031) was an independent protective factor for comorbid CMBs in the female AIS patients. However, these factors were not found to be independent risk or protective factors for comorbid CMBs in male AIS patients. Conclusion There are gender differences in the influencing factors for CMBs in AIS patients. Age, old LIs, and blood glucose are independent risk or protective factors for comorbid CMBs in female AIS patients, although they are not associated with the risk of developing CMBs in male AIS patients.

High Blood Pressure Increases the Risk of Cerebral Microbleeds in Hypertensive Individuals

Introduction: Hypertension is the leading preventable risk factor for major cardiovascular diseases worldwide. Recently, compelling evidence has emerged associating hypertension with cerebral microbleeds (CMBs), which are subclinical hemorrhages in the brain resulting from structural abnormalities in the small vessels that supply the brain. In addition to overall elevated blood pressure (BP), elevation in individual parameters such as systolic BP, diastolic BP, pulse pressure and mean arterial pressure could also individually be important risk factors for CMBs. This study aimed to assess the association between CMBs and blood pressure, and assess blood pressure parameters that could be possible risk factors for CMB. Methods: A retrospective case-control study was conducted from August 2021 to September 2022 on patients who underwent MRI due to primary complaints of limb disorders, loss of consciousness, persistent dizziness, and intermittent headaches. The patients were divided according to MRI results into 52 cases (those who had CMBs) and 52 controls (those who had no CMBs). Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted. Results: In total, 104 cases and control patients were assessed, with mean (±SD) age 70.6 ± 8.56 vs 68.9 ± 8.93 years respectively (p > 0.05). CMB patients had more cases of stroke, hyperlipidemia and diabetes than non-CMB patients. Systolic blood pressure (SBP), diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) were all considerably raised in CMB patients than non-CMBs patients. Blood pressure grades were positively correlated with the severity of CMBs (r = 0.22; p = 0.044). Logistic regression analysis showed that SBP and MAP were independent risk factors for CMBs (age and sex adjusted odds ratio = 1.420; 95% CI: 1.030 - 1.851, and 1.310; 95% CI: 1.011 - 1.631 respectively). Conclusions: In summary, this study found that hypertension was positively correlated with CMBs severity, and that SBP and MAP are independent risk factors for CMBs in patients with hypertension.

Abstract TP191: Three-month Daily Blood Pressure Monitoring Predicts Incident Stroke In CADASIL

Introduction: CADASIL is a hereditary small vessel disease caused by NOTCH3 mutations. Whether superimposed hypertension had harmful effects on these populations was unknown. Methods: We recruited 100 participants in the prospective cohort of Taiwan CADASIL Registry with documented NOTCH3 mutations , as well as 18 age- and sex-matched controls. Daily blood pressure (BP) and heart rate (HR) were recorded by the participants with a standardized home-based sphygmomanometer for consecutive 90 days. Linear analysis of the variability parameters was done. Neuroimaging markers of small vessel disease on brain magnetic resonance imaging and any incident stroke was documented. Results: Participants with NOTCH3 mutations are more likely to have stroke history and use antithrombotic or antihypertensive medications than controls. However, the systolic, diastolic BP, and pulse pressure were comparable, except for higher mean HR (77.3±10.0 vs 70.7±8.3, P =0.01) in the NOTCH3 group. In participants with NOTCH3 mutations, higher 90-day mean systolic and diastolic BP correlated with more cerebral microbleeds, while the mean, standard deviation, coefficient of variation, and average real variability of 90-day HR positively correlated with number of lacunes. During median follow-up of 24 months, there were 8 stroke events (5 ischemic, 3 hemorrhagic). Participants with persistent hypertension (90-day mean systolic/diastolic BP &gt; 130/80 mmHg) were more likely to have incident stroke (log-rank P = 0.04), and the effects persisted (hazard ratio 5.29, 95% CI 1.12 - 25.1) after adjustment of number of cerebral microbleeds. Conclusions: In participants with NOTCH3 mutations, persistent hypertension had detrimental effects on the severity of cerebral microbleeds as well as incident stroke. Aggressive blood pressure control seems beneficial in hereditary small vessel disease.

Association between periodontal disease due to Campylobacter rectus and cerebral microbleeds in acute stroke patients.

Oral health conditions and cerebral small vessel disease, such as white matter lesions or cerebral microbleeds (CMBs), are associated with the incidence of stroke. The purpose of this study was to examine the associations between oral health conditions (serum IgG titers of periodontal pathogens) with the presence or severity of CMBs in acute stroke patients. From January 2013 to April 2016, acute stroke patients were registered in two hospitals. Serum samples were evaluated for antibody titers against 9 periodontal pathogens using the ELISA method. The cut-off points for reactivity (the positive decision point) to each antigen were defined as more than a mean ELISA unit + 1 standard deviation (after logarithmic transformation) in all subjects. CMBs were evaluated on T2*-weighted MRI. In all, 639 patients were evaluated (ischemic, n = 533 and hemorrhagic, n = 106; 73.1 ± 12.9 years old). Among these patients, 627 were available for CMB evaluation. Among the 9 evaluated periodontal pathogens, only Campylobacter rectus (C. rectus) was associated with the presence of CMBs. the prevalence of positive serum antibody titers against C. rectus was higher among patients with CMBs than among those without CMBs (14.6% vs. 8.7%, P = 0.025). In addition, positive serum antibody titers against C. rectus remained one of the factors associated with the presence of CMBs in multivariate logistic analysis (odds ratio 2.03, 95% confidence interval 1.19-3.47, P = 0.010). A positive serum antibody titer against C. rectus was associated with the presence of CMBs in acute stroke patients.

Cerebral microbleeds are associated with blood pressure levels in individuals with hypertension

ABSTRACTObjective: Cerebral microbleeds (CMBs), which appear as small dot-like hypointense lesions, are strongly associated with cerebrovascular disease. Recently, numerous investigations have suggested that hypertension and age are risk factors for CMBs; however, whether blood pressure grade and age rank are related to the severity of CMBs remains unclear. The purpose of this research was to assess the association between cerebral microbleeds and blood pressure levels.Methods: In total, 460 consecutive hypertension patients (214 males and 246 females; aged 44–96 years, mean age 60.95 ± 6.82 years) from Lishui Central Hospital were enrolled and classified as CMB or non-CMB patients according to magnetic resonance imaging (MRI). Gradient echo T2*-weighted MRI was used to detect CMBs. Differences in blood pressure, CMB severity, and other patient characteristics were compared between the two groups. Multifactorial logistic regression was used to analyze the correlation between blood pressure and microbleeds.Results: In our study, CMB lesions were identified in 123 patients (26.7%), including 39 patients with CMB lesions located deep in the brain. In the hypertensive population, smoking is an independent risk factor for CMBs. Additionally, systolic blood pressure (SBP), diastolic blood pressure (DBP) and age are also independent risk factors for CMBs. Furthermore, a modest correlation was noted between the number of microbleeds and grade of hypertension.Conclusions: This study provides novel evidence that microbleed severity is associated with hypertension grade. This conclusion emphasizes the importance of antihypertensive therapy in hypertension patients to avoid an increase in CMBs.

An investigation on prevalence and severity of cerebral microbleeds in patients with different stroke classifications of cerebral infarction

Objective To investigate the prevalence and severity of cerebral microbleeds(CMBs) in patients with different stroke classifications of cerebral infarction. Methods From October 2016 to December 2017, the clinical data of patients with acute cerebral infarction in the Second Affiliated Hospital of Xuzhou Medical University were collected through the prospective study.The SWI technique was used to screen the CMBs.According to the TOAST and OCSP classifications, the prevalence and severity of CMBs in patients with different stroke classifications of cerebral infarction were analyzed. Results A total of 254 patients with cerebral infarction were enrolled, there were 136 patients(53.54%) in CMBs group and 118 patients(46.46%) in no CMBs group.The prevalence of CMBs in patients with different TOAST classifications was large artery atherosclerosis(54.29%), small-artery occlusion(64.15%), cardioembolism(40.43%), stroke of other determined etiology(33.33%), stroke of undetermined etiology(38.46%), and the difference was statistically significant(χ2=12.206, P=0.016). The prevalence of CMBs in patients with different OCSP classifications was total anterior circulation infarcts(43.75%), partial anterior circulation infarcts(51.19%), posterior circulation infarcts(49.18%), lacunar infarcts(67.53%), and the difference was statistically significant(χ2=8.944, P=0.030). The severity of CMBs in patients with different TOAST classifications was large artery atherosclerosis[mild(55.26%), moderate(26.32%), severe(15.79%)], small-artery occlusion[mild(25.00%), moderate(33.82%), severe(41.18%)], cardioembolism[mild(57.89%), moderate(26.32%), severe(15.79%)), stroke of other determined etiology[mild(50.00%), moderate(33.33%), severe(16.67%)], stroke of undetermined etiology[mild(60.00%), moderate(20.00%), severe(20.00%)], and the difference was statistically significant(Fisher exact test, P=0.025). The severity of CMBs in patients with different OCSP classifications was total anterior circulation infarcts[mild(57.14%), moderate(28.57%), severe(14.29%)], partial anterior circulation infarcts[mild(52.50%), moderate(32.50%), severe(15.00%)], posterior circulation infarcts[mild(50.00%), moderate(33.33%), severe(16.67%)], lacunar infarcts[mild(25.00%), moderate(32.69%), severe(42.31%)], and the difference was statistically significant(Fisher exact test, P=0.023). Conclusion The prevalence and severity of CMBs in patients with different stroke classifications of cerebral infarction are variable.The prevalence of CMBs in small-artery occlusion and lacunar infarcts are the highest and give first place to severe CMBs(number of lesions≥10). We should pay attention to these two stroke classifications by early recognition and taking targeted clinical strategies. Key words: Stroke; Cerebral infarction; Cerebral hemorrhage; Prevalence; Magnetic resonance imaging

Correlation between antiplatelet therapy in secondary prevention of acute cerebral infarction and cerebral microbleeds: A susceptibility-weighted imaging (SWI) study.

To investigate the clinical significance of antiplatelet aggregation therapy for patients diagnosed with acute cerebral infarction (ACI) complicated with the cerebral microbleeds (CMBs). Thirty patients with ACI and 36 patients with intracerebral hemorrhage (ICH) were included in this research. Two groups, studied by susceptibility-weighted imaging (SWI), were compared in terms of the number, location, and severity of CMBs. Then, 30 cases of ACI patients were divided into CMBs sub-group and non-CMBs sub-group. Univariate analysis between these two sub-groups was performed to determine the risk factors regarding the incidence of CMBs. For ACI patients, the number of CMBs before and after applying anti-platelet treatment were compared to examine the impacts of anti-platelet treatment on hemorrhagic transformation. CMBs were found to be more prevalent and severe in ICH patients than in ACI patients. CMBs in patients with ICH were more severe than in patients with ischemic stroke (IS), which indicates that CMBs closely relate to ICH. Hypertension and leukoaraiosis were found to have significant effects on the incidence of CMBs. After anti-platelet treatment, patients with CMBs (≥5) increased the number of CMB, whereas there was no obvious effect on patients with the CMBs less than 5 or no CMBs. The number of CMBs increased significantly among ACI patients with 5 or more CMBs before the anti-platelet treatment. CMBs are more frequently found in patients with hemorrhagic stroke than in patients with ischemic stroke, and more severe than the latter, which suggests that the clinical impact of higher association between the increase of the number of the CMBs and the hemorrhagic stroke.

Correlation study between cerebral microbleeds and white matter lesions in patients with ischemic cerebrovascular disease

Objective To explore distribution characteristics and risk factors of cerebral microbleeds (CMBs), and the correlation between CMBs and white matter lesions (WML) in patients with ischemic cerebrovascular disease(ICVD). Methods 180 patients with ICVD in neurology department of Hebei General Hospital from February 2015 to January 2017 were recruited.Those patients were underwent brain magnetic resonance imaging (MRI), and magnetic susceptibility weighted imaging (SWI). Recorded the baseline data and risk factors of high blood pressure, diabetes, hyperlipidemia, and high homocysteine were recorded.Patients with CMBs were counted and graded to understand the characteristics of CMBs distribution. Logisitic regression analysis was used to analyze the influencing factors.ICVD patients were divided into CMBs group and non CMBs group. CMBs group was further divided into 4 groups according to the severity, which was divided into level 1-3. The correlation between CMBs influencing factors and classification was further studied.Then patients with ICVD were divided into WML group and non WML group. WML group scored each region with age-related white matter changes rating scale(ARWMCrs). The correlation between WML and CMBs classification was further studied. Results (1) The overall prevalence of CMBs in patients with ICVD was 61.7%(111/180). The most common location of CMBs in patients with ICVD was the cortical and subcortical regions (80/111, 72.1%), followed by the basal ganglia and thalamus regions (61/111, 55.0%), and the infratentorial regions(38/111, 34.2%). The difference between them were significant (χ2=32.061, P= 0.000). In cortical and subcortical regions of CMBs, temporal lobe was the most common(61.3%). (2) Age(B=0.046, Or=1.047, 95%CI=1.017~1.077, P=0.002) and the high homocysteine(B=1.458, Or=4.299, 95%CI=2.114~8.744, P<0.001)were the risk factors for CMBs.(3) Four classification of CMBs was positively correlated with and WML total score (r=0.393, P=0.393). Conclusion The temporal lobe was the most common region for CMBs in patients with ICVD.Age and high homocysteine were risk factors for CMBs.With the increase of WML total score, severity of CMBs was also increased. Key words: Ischemic cerebrovascular disease; Cerebral microbleeds; Risk factors; White matter lesions; Correlation

Independent Correlation of Serum Homocysteine with Cerebral Microbleeds in Patients with Acute Ischemic Stroke due to Large-Artery Atherosclerosis

The severity of cerebral microbleeds (CMBs) affected the prognosis of patients with acute cerebrovascular disease. Considering the impact of CMBs on clinical decision, it is necessary to assess the risk factors of CMBs. We aimed to evaluate the independent risk factors of CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. 112 patients were enrolled in the study. The baseline information, the results of laboratory examination and cranial MRI were collected. The independent risk factors of CMBs in patients with acute ischemic stroke due to large-artery atherosclerosis were evaluated. CMBs were found in 56 (50%) patients. Older age and higher homocysteine (Hcy) level were associated with an elevated chance of occurrence of CMBs. Further, there was a positive correlation between CMBs grade and serum Hcy level. Serum Hcy level is strongly associated with the presence of CMBs in patients with acute ischemic stroke due to large-artery atherosclerosis. Serum Hcy level may be a potential therapeutic target for alleviating adverse clinical outcomes of CMBs.

Impact of cerebral microbleeds on outcomes of acute ischemic stroke treated with intravenous thrombolysis

To assess the impact of cerebral microbleeds (CMBs) on clinical outcomes in patients with acute ischemic stroke treated by intravenous thrombolysis. The clinical data of 225 patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator therapy in the Second Affiliated Hospital, Zhejiang University School of Medicine from June 2009 to May 2013 were reviewed. The severity of CMBs and hemorrhagic transformation (HT) after thrombolytic therapy and clinical neurological outcome based on modified Rankin scale (mRS) at 3 months were evaluated. Favorable outcome was defined as mRS 0-1 and unfavorable outcome as mRS 2-6. Multivariate logistic-regression analysis and binary logistic-regression were used to determine independent risk factors of HT and favorable outcome. The mean age of 225 patients was (66.29±13.01) y, 73 (32.4%) patients were women, mean pretreatment National Institutes of Health Stroke Scale (NIHSS) score was 11.40±5.89, and onset-to-needle time was (238.40±89.16) min. Totally, 522 CMBs were detected in 91 patients (36.1%). Postlytic radiological HT was found in 64 patients (28.4%), among which 43 (19.1%) were hemorrhagic infarction and 21 (9.3%) were parenchymal hematoma. Univariate analysis showed that patients with HT had higher NIHSS score and more incidence of atrial fibrillation and that patients with unfavorable outcome were older and had higher NIHSS score and more CMBs. Multivariate logistic regression analysis showed that multiple CMBs (>=3) was independently associated with parenchymal hematoma (OR=4.957, 95%CI 1.306-18.811, P=0.019), but not with hemorrhagic infarction (OR=1.204, 95%CI 0.386-3.754, P=0.749). Binary logistic regression analysis showed that multiple CMBs (>=3) was independently associated with unfavorable outcome (OR=3.496, 95%CI 1.381-8.849, P=0.008). Multiple CMBs are correlated with parenchymal hematoma and unfavorable neurological outcome after thrombolytic therapy in patients with acute ischemic stroke.

Three-tesla magnetic resonance imaging study of cerebral microbleeds in patients with ischemic stroke

Objectives: The aims of this study were to analyse the distribution of cerebral microbleeds (CMBs) in patients with ischemic stroke and study the relationship between CMBs and the severity of old lacunar infarcts and cerebral white matter changes.Methods: The study population consisted of 247 consecutive inpatients with ischemic stroke. Magnetic resonance imaging findings of these inpatients were observed. CMBs were counted respectively according to their locations, including the corticosubcortical regions, basal ganglia, thalami, brainstem and cerebellum. The number of the old lacunes and the severity of the cerebral white matter changes were also recorded. Based on the occurrence of CMBs, the patients were divided into two groups (72 patients with CMBs; 175 patients without CMBs).Results: The most common location of CMBs in patients with ischemic stroke was the basal ganglia, followed by the corticosubcortical region, the thalami, the brainstem and the cerebellum. The severity of CMBs was closely correlated with the severity of lacunar infarcts and cerebral white matter changes, respectively.Discussion: CMBs are closely related with cerebral microangiopathy and may be a marker of advanced stage cerebral microangiopathy.

Comparative analysis of the spatial distribution and severity of cerebral microbleeds and old lacunes

Background: Cerebral microbleeds, which result from microangiopathic changes following chronic hypertension, may reflect bleeding-prone microangiopathy. However, the distribution of these lesions has not been compared with that of lacunes, which...