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Published on: April 14, 2014
MRI evidence of past cerebral microbleeds in a healthy elderly population
G Roob1, R Schmidt, P Kapeller
1Department of Neurology, Karl-Franzens University, Graz, Austria.
Background:
Incidental foci of signal loss suggestive of past microbleeds are a frequent finding on gradient-echo T2-weighted MRI of patients with nontraumatic intracerebral hemorrhage and have been associated with bleeding-prone microangiopathy. If and to what extent such lesions may also occur in the normal population is unclear.
Objective:
To determine focal hypointensities in asymptomatic elderly individuals and their relation to other clinical and morphologic variables.
Methods:
T2-weighted MRI of the brain was performed in a consecutive series of 280 participants (mean age 60 years, range 44 to 79) of the Austrian Stroke Prevention Study. This cohort consisted of randomly selected individuals without history or signs of neuropsychiatric disorder.
Results:
Past microbleeds ranging from one to five foci of signal loss were seen in 18 (6.4%) individuals. They were strongly associated with higher age, hypertension, and lacunes (p < 0.001), and extensive white matter damage was more frequently noted (p = 0.02). Hypertension was present in all individuals with focal hypointensities in the basal ganglia and infratentorially but in only 5 of 10 volunteers with microbleeds limited to cortico-subcortical sites (p = 0.04).
Conclusions:
MRI evidence of past microbleeds may be found even in neurologically normal elderly individuals and is related, but not restricted, to other indicators of small vessel disease. The predictive potential of this finding regarding the risk of intracerebral bleeding requires further investigation.
Insights
Past microbleeds, visible on MRI, can occur in healthy older adults. These findings are linked to aging and hypertension, suggesting a connection to small vessel disease.
Area of Science:
- Neurology
- Radiology
- Geriatrics
Background:
- Gradient-echo T2-weighted MRI often reveals signal loss suggestive of microbleeds in patients with intracerebral hemorrhage.
- These microbleeds are linked to bleeding-prone microangiopathy.
- The occurrence of microbleeds in the general elderly population remains unclear.
Purpose of the Study:
- To investigate the presence of focal hypointensities (suggestive of microbleeds) in asymptomatic elderly individuals.
- To determine the relationship between these findings and clinical/morphological variables.
Main Methods:
- Brain MRI (T2-weighted) was conducted on 280 participants (mean age 60) from the Austrian Stroke Prevention Study.
- Participants were randomly selected, asymptomatic individuals without a history of neuropsychiatric disorders.
Main Results:
- Microbleeds (1-5 foci) were observed in 18 individuals (6.4%).
- Microbleeds showed a strong association with older age, hypertension, and lacunes (p < 0.001).
- Extensive white matter damage was more frequent (p = 0.02), and hypertension was prevalent in those with basal ganglia/infratentorial microbleeds.
Conclusions:
- MRI evidence of past microbleeds can be present in neurologically normal elderly individuals.
- These findings are related to, but not exclusively indicative of, small vessel disease.
- Further research is needed to ascertain the predictive value of microbleeds for intracerebral bleeding risk.
