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Clinical and radiologic differences between primary intracerebral hemorrhage with and without microbleeds on

Sang-Wuk Jeong1, Keun-Hwa Jung, Kon Chu

  • 1Department of Neurology, Ilsan Paik Hospital, Inje University, Ilsan, Korea.

Archives of Neurology
|June 24, 2004
PubMed
Abstract

Insights

Microbleeds in primary intracerebral hemorrhage (PICH) are linked to older age, ischemic changes, and antithrombotic use. Younger PICH patients with precipitating events are less likely to have microbleeds.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Microbleeds on gradient-echo MR imaging indicate bleeding-prone microangiopathy.
  • Microbleeds are often found in patients with primary intracerebral hemorrhage (PICH).
  • However, the absence of microbleeds in some PICH patients requires further investigation.

Purpose of the Study:

  • To identify risk factors associated with microbleeds in PICH.
  • To gain insights into the pathogenesis of PICH.

Main Methods:

  • Prospective study involving 107 consecutive PICH patients at a tertiary referral center.
  • Gradient-echo MR imaging was used to assess microbleed patterns and numbers.
  • Clinical variables and MR imaging abnormalities were compared between PICH patients with and without microbleeds.

Main Results:

  • Patients with PICH and microbleeds were significantly older and more likely to have a history of stroke, use antithrombotics/anticoagulants, and exhibit lacunes and leukoaraiosis.
  • Conversely, precipitating events that raise blood pressure were more common in PICH patients without microbleeds.
  • Independent risk factors for microbleeds included advanced age, leukoaraiosis, number of lacunes, and absence of precipitating events.

Conclusions:

  • PICH without microbleeds is associated with younger age and precipitating events.
  • PICH with microbleeds is more prevalent in elderly individuals with ischemic changes and antithrombotic/anticoagulant use.
  • These findings may aid in classifying PICH subtypes for targeted secondary prevention strategies.

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