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Asymptomatic microbleeds as a risk factor for aspirin-associated intracerebral hemorrhages
1Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin. ks-wong@cuhk.edu.hk
Abstract:
The authors measured the presence and extent of asymptomatic microbleeds on gradient-recalled-echo MRI in 21 aspirin users who developed intracerebral hemorrhage and 21 aspirin users without history of intracerebral hemorrhage. Microbleeds were more frequent (19 vs 7, p < 0.001) and more extensive (mean number of microbleeds 13.3 vs 0.4, p < 0.001) in the intracerebral hemorrhage group than in the control group. Asymptomatic microbleeds may be a risk factor for aspirin-associated intracerebral hemorrhage.
Insights
Asymptomatic microbleeds detected by gradient-recalled-echo MRI are more common in patients who experience intracerebral hemorrhage while using aspirin. These findings suggest microbleeds may indicate a higher risk for this serious condition.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Intracerebral hemorrhage (ICH) is a severe neurological event.
- Aspirin is commonly used for cardiovascular prevention but is associated with an increased risk of bleeding.
- The role of cerebral microbleeds in aspirin-associated ICH is not fully understood.
Purpose of the Study:
- To investigate the association between asymptomatic cerebral microbleeds and the occurrence of intracerebral hemorrhage in aspirin users.
- To compare the frequency and extent of microbleeds in aspirin users with and without a history of ICH.
Main Methods:
- Gradient-recalled-echo (GRE) Magnetic Resonance Imaging (MRI) was used to detect microbleeds.
- The study included 21 aspirin users with ICH and 21 aspirin users without ICH (control group).
- Microbleed presence and number were quantified in both groups.
Main Results:
- Asymptomatic microbleeds were significantly more frequent in the ICH group (19 participants) compared to the control group (7 participants) (p < 0.001).
- The mean number of microbleeds was substantially higher in the ICH group (13.3) versus the control group (0.4) (p < 0.001).
Conclusions:
- Asymptomatic cerebral microbleeds are more prevalent and extensive in aspirin users who develop intracerebral hemorrhage.
- The presence of asymptomatic microbleeds may serve as a potential risk factor for aspirin-associated intracerebral hemorrhage.
- GRE MRI is a valuable tool for identifying microbleeds that could predict bleeding risk in aspirin users.