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Brain microbleeds as a potential risk factor for antiplatelet-related intracerebral haemorrhage: hospital-based,

S M Gregoire1, H R Jäger, T A Yousry

  • 1Stroke Research Group, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|June 5, 2010
PubMed
Abstract

Insights

Brain microbleeds detected by MRI are linked to a higher risk of intracerebral haemorrhage (ICH) in patients taking antiplatelet medication. Identifying these microbleeds may help predict ICH risk before starting antiplatelet therapy.

Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Medicine

Background:

  • Intracerebral haemorrhage (ICH) is a severe complication of antiplatelet therapy.
  • Brain microbleeds on MRI are potential biomarkers for small-vessel disease and bleeding risk.
  • Identifying patients at high risk for ICH is crucial to mitigate treatment hazards.

Purpose of the Study:

  • To investigate whether brain microbleeds are a risk factor for antiplatelet-related ICH.
  • To assess the association between microbleeds and the occurrence of ICH in patients using antiplatelet drugs.

Main Methods:

  • A hospital-based, matched case-control study was conducted.
  • Cases of spontaneous ICH were identified from a prospective database.
  • Two controls per case were matched for age, sex, and hypertension, without prior ICH or antiplatelet use; microbleeds were assessed by a blinded observer.

Main Results:

  • Microbleeds were significantly more frequent in patients with antiplatelet-related ICH (81%) compared to controls (19%) and non-antiplatelet-related ICH (45%).
  • The number of microbleeds was associated with an increased risk of antiplatelet-related ICH (adjusted OR 1.33 per additional microbleed).
  • Lobar microbleeds were also more common in the antiplatelet-related ICH group.

Conclusions:

  • Brain microbleeds are significantly associated with an increased risk of intracerebral haemorrhage in patients using antiplatelet therapy.
  • A high number of lobar microbleeds may indicate that the risks of antiplatelet therapy outweigh the benefits.
  • Further prospective studies are recommended to confirm the prognostic value of microbleeds in regular antiplatelet users.

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