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Relations of blood inflammatory marker levels with cerebral microbleeds
Kaori Miwa1, Makiko Tanaka, Shuhei Okazaki
1Department of Neurology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. miwa@osaka-njm.net
Insights
Inflammation is linked to cerebral microbleeds (CMB). Higher levels of inflammatory markers like hsCRP, IL-6, and IL-18 were associated with the presence and location of CMB in elderly patients.
Area of Science:
- Neurology
- Vascular Biology
- Immunology
Background:
- Cerebral microbleeds (CMB) are markers of small vessel disease, common in the elderly.
- The role of inflammation in CMB development is not fully understood.
- Inflammatory processes are implicated in both large and small vessel diseases.
Purpose of the Study:
- To investigate the relationship between inflammatory marker levels and the presence of CMB.
- To determine if inflammation plays a role in the pathogenesis of CMB.
Main Methods:
- Prospective enrollment of 431 patients without prior cerebrovascular disease.
- Assessment of CMB presence and number using gradient-echo MRI.
- Measurement of serum levels for high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and interleukin-18 (IL-18).
Main Results:
- CMB were detected in 15% of patients (65 out of 431).
- Patients with CMB showed higher levels of hsCRP, IL-6, and IL-18 compared to those without.
- Elevated levels of these inflammatory markers were significantly associated with the presence of CMB, even after adjusting for cardiovascular risk factors.
Conclusions:
- Increased levels of hsCRP, IL-6, and IL-18 are associated with CMB.
- Inflammation appears to be involved in the development of both deep and lobar CMB.
- These findings highlight the potential role of inflammatory pathways in small vessel disease affecting the brain.
Background And Purpose:
Cerebral microbleeds (CMB) are observed in the elderly and have been regarded as one of the manifestations of small vessel disease. Although inflammatory processes have attracted much attention not only in large-artery disease, but also in small vessel disease, their involvement in CMB remains to be determined. The purpose of this study is to clarify relations between inflammatory marker levels and CMB.
Methods:
Four hundred thirty-one patients without histories of cerebrovascular diseases were prospectively enrolled. The presence and number of CMB were assessed on gradient-echo magnetic resonance imaging. As common inflammatory markers, serum levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and interleukin-18 (IL-18) were evaluated.
Results:
CMB were found in 65 patients (15%). In 35 patients, at least one CMB was found in deep locations, but 30 patients had strictly lobar CMB. Levels of hsCRP, IL-6, and IL-18 were higher in patients with CMB than in those without. Logistic regression analyses showed that each 1SD increase in each inflammatory marker level was significantly associated with the presence of CMB after adjustment for age and sex, and after additional adjustment for cardiovascular risk factors, silent lacunar infarction, and white matter hyperintensity. The OR (95% CI) of hsCRP, IL-6, and IL-18 was 1.81 (1.35-2.46), 1.73 (1.18-2.61), and 2.41 (1.44-4.52), respectively. Furthermore, the inflammatory marker levels were associated with both deep and lobar CMB.
Conclusions:
Higher levels of hsCRP, IL-6, and IL-18 are associated with CMB, in both deep and lobar locations, suggesting the involvement of inflammation in CMB.
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