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Cerebral microhemorrhages predict new disabling or fatal strokes in patients with acute ischemic stroke or transient

Jean-Martin Boulanger1, Shelagh B Coutts, Michael Eliasziw

  • 1Clinique Neuro Rive-Sud, 4896 Blvd Taschereau 250, Greenfield Park, Provinvr of Quebec, Canada, J4V 2J2. jbouboul@hotmail.com.

Stroke
|February 14, 2006
PubMed
Abstract

Insights

Cerebral microhemorrhages (MHs) in acute stroke patients predict disabling or fatal strokes. The increased risk is primarily due to recurrent ischemic events, not hemorrhagic ones.

Area of Science:

  • Neurology
  • Neuroimaging
  • Stroke Medicine

Background:

  • Cerebral microhemorrhages (MHs) are frequently observed in patients experiencing acute ischemic stroke.
  • MHs may serve as indicators for future ischemic and hemorrhagic stroke events.

Purpose of the Study:

  • To investigate the predictive value of MHs for subsequent disabling or fatal strokes.
  • To assess the association between MHs and the risk of symptomatic intracerebral hemorrhage.

Main Methods:

  • Prospective study of patients with and without MHs within 12 hours of ischemic stroke or TIA diagnosis.
  • Magnetic resonance (MR) imaging performed within 24 hours of symptom onset.
  • Primary outcome measured as disabling or fatal stroke at 18 months.

Main Results:

  • MR scans were conducted on 236 patients; 19.1% showed MHs.
  • Patients with MHs had a 2.8-fold increased likelihood of subsequent disabling or fatal stroke (10.8% vs. 4.0%, P=0.036).
  • No statistically significant difference in symptomatic intracerebral hemorrhage risk was found between groups (3.3% vs. 0.8%, P=0.31).

Conclusions:

  • The presence of cerebral MHs in acute stroke or TIA patients predicts recurrent disabling and fatal strokes.
  • The elevated risk is predominantly driven by subsequent ischemic strokes.

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