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Cerebral microbleeds are associated with lacunar stroke defined clinically and radiologically, independently of white

Joanna M Wardlaw1, Stephanie C Lewis, Sarah L Keir

  • 1Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Rd, Edinburgh, EH4 2EX, UK. joanna.wardlaw@ed.ac.uk

Stroke
|September 2, 2006
PubMed
Abstract

Insights

Microbleeds are more common in lacunar stroke, suggesting a shared microvascular cause. This finding helps clarify the link between microbleeds and lacunar stroke subtypes.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Cerebral microbleeds, white matter lesions (WMLs), and small deep infarcts are often associated.
  • The relationship between microbleeds and clinically diagnosed lacunar stroke remains unclear, as many infarcts are asymptomatic.
  • A link between microbleeds and lacunar stroke could indicate a common underlying microangiopathy.

Purpose of the Study:

  • To investigate the association between microbleeds and clinicoradiologically defined stroke subtypes.
  • To determine if microbleeds are specifically linked to lacunar stroke compared to other stroke types or healthy controls.

Main Methods:

  • Magnetic Resonance Imaging (MRI) was performed on patients with lacunar, anterior circulation, or posterior circulation stroke syndromes, and on older healthy subjects.
  • Microhemorrhages, infarcts, hemorrhages, and WMLs were assessed blind to clinical information.
  • A final clinicoradiologic diagnosis for stroke subtype was assigned.

Main Results:

  • Of 308 subjects (241 stroke patients, 67 healthy controls), 54 (17%) had microbleeds.
  • Microbleeds were significantly more frequent in lacunar stroke (26%) compared to cortical stroke (13%) or healthy subjects (9%).
  • Microbleed presence was associated with higher white matter lesion (WML) scores, although WML scores were similar across lacunar, cortical stroke, and healthy groups.

Conclusions:

  • Microbleeds are more strongly associated with clinicoradiologically defined lacunar stroke than other stroke subtypes.
  • This association is independent of white matter lesion burden, suggesting a common microvascular abnormality.
  • The findings support a shared pathophysiology between microbleeds and lacunar stroke.

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