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Updated: Sep 20, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Brain microhemorrhages detected on T2*-weighted gradient-echo MR images
Yoshito Tsushima1, Jun Aoki, Keigo Endo
1Department of Radiology, Motojima General Hospital, Ohta, Gunma, Japan.
Background And Purpose:
Multifocal microhemorrhages have been reported to be commonly found in the brain of patients with systemic hypertension and spontaneous brain hemorrhage. The factors associated with these lesions detected on T2*-weighted gradient-echo images were examined to determine whether these lesions serve to indicate different types of microangiopathy and to predict a patient's risk for symptomatic hemorrhage.
Methods:
The study population consisted of 2164 patients who underwent 2416 consecutive brain MR imaging studies performed during 3 years. The patients with intracerebral hemorrhages due to vascular malformations, neoplasms, trauma, or intracranial surgery and those with incomplete medical records were excluded; 2019 cases were analyzed.
Results:
The overall incidence of microhemorrhages was 9.8%, predominantly in the lentiform nucleus (n = 96), thalamus (n = 88), and cortical-subcortical region (n = 93). Presence of microhemorrhages had the highest significant correlation with history of hemorrhagic stroke (P <.0001); advancing age, hypertension, and prominent white matter hyperintensity on T2-weighted images had the next highest significant correlation. Cortical-subcortical microhemorrhages were more frequently observed in patients who had previous lobar hemorrhagic stroke (P <.005). Among 139 patients with microhemorrhages who could be clinically followed up for more than 1 month, four (2.9%) had new hemorrhagic stroke.
Conclusion:
The presence of microhemorrhages may be not only a direct marker of bleeding-prone small-vessel diseases but also an indicator of different types of microangiopathy and a predictor of further hemorrhagic stroke.
Insights
Brain microhemorrhages are linked to hypertension and stroke history. Their presence may indicate small-vessel disease and predict future hemorrhagic stroke risk.
Area of Science:
- Neuroimaging
- Neurology
- Vascular Medicine
Background:
- Multifocal microhemorrhages are common in patients with systemic hypertension and spontaneous brain hemorrhage.
- T2*-weighted gradient-echo MRI is used to detect these lesions.
Purpose of the Study:
- To identify factors associated with microhemorrhages.
- To determine if microhemorrhages indicate different microangiopathies.
- To predict the risk of symptomatic hemorrhage.
Main Methods:
- Analysis of 2019 brain MRI studies from 2164 patients over 3 years.
- Exclusion of hemorrhages from vascular malformations, neoplasms, trauma, or surgery.
- Correlation analysis of microhemorrhage presence with clinical factors.
Main Results:
- Overall microhemorrhage incidence was 9.8%, most frequent in the lentiform nucleus, thalamus, and cortical-subcortical regions.
- Significant correlations found with history of hemorrhagic stroke, age, hypertension, and white matter hyperintensity.
- Cortical-subcortical microhemorrhages were more common in patients with prior lobar hemorrhagic stroke.
Conclusions:
- Microhemorrhages can be a marker for bleeding-prone small-vessel diseases.
- These lesions may indicate diverse microangiopathies.
- The presence of microhemorrhages predicts a higher risk of future hemorrhagic stroke.
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