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Multiple cerebral microbleeds in hyperacute ischemic stroke: impact on prevalence and severity of early hemorrhagic

Ho Sung Kim1, Deok Hee Lee, Chang Woo Ryu

  • 1Department of Radiology, Neuroradiology, and Research Institute of Radiology, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, South Korea.

AJR. American Journal of Roentgenology
|April 25, 2006
PubMed
Abstract

Insights

Cerebral microbleeds were not found to be independent risk factors for early hemorrhagic transformation or symptomatic hemorrhage following thrombolytic therapy in acute ischemic stroke patients. Further large-scale studies are required to validate these findings.

Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Hyperacute ischemic stroke requires prompt thrombolytic therapy.
  • Cerebral microbleeds are potential indicators of cerebrovascular disease.
  • The relationship between microbleeds and post-thrombolysis complications requires further investigation.

Purpose of the Study:

  • To determine if cerebral microbleeds are associated with early hemorrhagic transformation after thrombolytic therapy for acute ischemic stroke.
  • To assess the correlation between the number of microbleeds and the occurrence of symptomatic hemorrhage.

Main Methods:

  • Retrospective evaluation of 279 patients with suspected ischemic stroke undergoing MRI within 6 hours of symptom onset.
  • Inclusion criteria: anterior circulation infarct, no prior hemorrhage, thrombolytic treatment, and available follow-up MRI.
  • Microbleed grading: absent (grade 1), mild (grade 2), moderate (grade 3), and severe (grade 4).

Main Results:

  • 65 patients met inclusion criteria; 25 had microbleeds.
  • Early hemorrhagic transformation occurred in 9/40 patients without microbleeds and 8/25 patients with microbleeds.
  • Multivariate logistic regression indicated no association between microbleed presence and hemorrhagic transformation.

Conclusions:

  • The presence and number of cerebral microbleeds are not independent risk factors for early hemorrhagic transformation or symptomatic hemorrhage after thrombolytic therapy in acute ischemic stroke.
  • Larger studies are needed to confirm these findings and their clinical implications.

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