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Related Experiment Video

Updated: Jun 23, 2026

Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats
06:39

Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats

Published on: October 17, 2018

Microbleeds versus macrobleeds: evidence for distinct entities.

Steven M Greenberg1, R N Kaveer Nandigam, Pilar Delgado

  • 1MGH Stroke Research Center, Harvard Medical School, Boston, MA 02114, USA. sgreenberg@partners.org

Stroke
|May 16, 2009
PubMed
Summary

Cerebral amyloid angiopathy-associated microbleeds and macrobleeds appear to be distinct conditions, not a single continuum. Thicker vessel walls may contribute to microbleed formation in this condition.

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Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Small, asymptomatic microbleeds often coexist with larger symptomatic macrobleeds.
  • The relationship between microbleeds and macrobleeds in cerebral amyloid angiopathy (CAA) remains unclear, questioning if they are part of a single spectrum or distinct pathological events.

Purpose of the Study:

  • To investigate whether microbleeds and macrobleeds in CAA represent distinct entities or a continuous spectrum.
  • To explore potential pathophysiological differences between microbleeds and macrobleeds in CAA.

Main Methods:

  • Retrospective analysis of gradient-echo MRI scans from 46 patients with symptomatic lobar intracerebral hemorrhage due to probable or possible CAA.
  • Radiographic analysis of hemorrhagic lesion volumes and neuropathologic examination of amyloid-positive vessel segments in autopsied subjects with high versus low microbleed counts.

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Last Updated: Jun 23, 2026

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Published on: October 17, 2018

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Published on: April 23, 2021

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Main Results:

  • Hemorrhagic lesion volumes exhibited a bimodal distribution, suggesting two distinct size categories.
  • Neuropathologic analysis revealed significantly thicker amyloid-positive vessel walls in autopsied subjects with a high microbleed burden compared to those with a low burden.

Conclusions:

  • Findings suggest that microbleeds and macrobleeds in CAA are distinct entities.
  • Increased cerebral amyloid angiopathy vessel wall thickness may be a predisposing factor for microbleed development.