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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

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Cerebral microbleeds and recurrent stroke risk: systematic review and meta-analysis of prospective ischemic stroke

Andreas Charidimou1, Puneet Kakar, Zoe Fox

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

Stroke
|March 16, 2013
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) significantly increase stroke risk, particularly intracerebral hemorrhage (ICH), after ischemic events. The risk balance between ICH and recurrent ischemic stroke (IS) varies between Asian and Western populations.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cerebral microbleeds (CMBs) are increasingly recognized markers in cerebrovascular disease.
  • Their association with future stroke risk, especially intracerebral hemorrhage (ICH), requires further elucidation.

Purpose of the Study:

  • To evaluate the association between cerebral microbleeds (CMBs) and the risk of future stroke, including ICH, in patients with a history of ischemic stroke (IS) or transient ischemic attack (TIA).

Main Methods:

  • Systematic review and meta-analysis of prospective cohort studies.
  • Inclusion of data from 10 cohorts comprising 3067 patients.
  • Pooled odds ratios (ORs) calculated to assess the risk of ICH and recurrent IS in patients with and without CMBs.

Main Results:

  • CMBs significantly increased the risk of any recurrent stroke (OR, 2.25), ICH (OR, 8.52), and IS (OR, 1.55).
  • The association of CMBs with ICH was stronger in Asian cohorts (OR, 10.43) compared to Western cohorts (OR, 3.87).
  • CMBs were associated with recurrent IS in Western cohorts (OR, 2.23) but not significantly in Asian cohorts (OR, 1.30).

Conclusions:

  • Consistent evidence indicates an elevated risk of recurrent stroke in patients with CMBs post-IS or TIA.
  • The risk of spontaneous ICH appears higher than recurrent IS in patients with CMBs.
  • Ethnic differences in the risk balance between ICH and IS associated with CMBs were observed between Asian and Western populations.

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