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Silent microbleeds and old hematomas in spontaneous cerebral hemorrhages

Jae-Bum Lim1, Ealmaan Kim

  • 1Division of Skull Base Surgery, Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Journal of Korean Neurosurgical Society
|August 27, 2009
PubMed
Abstract

Insights

Silent cerebral microbleeds (MBs) and old hematomas (OHs) are common in patients with intracerebral hemorrhages (ICHs). These findings correlate with hypertension and white matter changes, particularly in the deep brain regions.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Intracerebral hemorrhage (ICH) is a serious neurological condition.
  • Understanding associated microvascular changes is crucial for risk stratification and management.
  • Silent cerebral microbleeds (MBs) and old hematomas (OHs) are potential markers of underlying cerebrovascular disease.

Purpose of the Study:

  • To investigate the risk factors for MBs and OHs in patients with ICH.
  • To examine the association between MBs, OHs, and concurrent magnetic resonance (MR) imaging findings.
  • To explore the topographic correlation of these lesions within the brain.

Main Methods:

  • Retrospective study of 234 primary hemorrhagic stroke patients.
  • Evaluation using computed tomography (CT) and 3.0-tesla MR imaging within the first week of admission.
  • Assessment of MBs and OHs using T2*-weighted gradient-echo (GRE) MR imaging; comparison of clinical, laboratory, and MR imaging data between groups with and without MBs/OHs.

Main Results:

  • MBs were found in 79.5% of patients; OHs were detected in 19.2%.
  • MBs, OHs, and ICHs were most commonly located in the ganglionic/thalamic region.
  • Both MBs and OHs were associated with chronic hypertension and advanced white matter and periventricular hyperintensities (WMHs, PVHs). MB prevalence and number correlated more strongly with OHs.

Conclusions:

  • MBs and OHs are prevalent in ICH patients and correlate with hypertension and cerebral white matter microangiopathy.
  • A significant topographic correlation exists between MBs, OHs, and ICHs, particularly in the deep thalamo-basal region.
Keywords:
Cerebral hemorrhageHypertensionLeukoaraiosisMagnetic resonance imagingMicrobleed

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