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Nascent lobar microbleeds and stroke recurrences

Toshio Imaizumi1, Shigeru Inamura1, Ikuhide Kohama1

  • 1Department of Neurosurgery, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro, Hokkaido 085-0822, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|June 27, 2013
PubMed
Abstract

Insights

Nascent lobar microbleeds (MBs) detected on MRI may indicate a higher risk for deep intracerebral hemorrhages (ICHs). This association suggests MBs could be a predictor for future ICH events in at-risk patients.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Research

Background:

  • Lobar microbleeds (MBs) are sometimes observed on T2*-weighted MRI in patients with deep intracerebral hemorrhages (ICHs).
  • The relationship between nascent lobar MBs and the development of deep ICHs requires further investigation.

Purpose of the Study:

  • To investigate the potential contribution of nascent lobar microbleeds to the occurrence of deep intracerebral hemorrhages.
  • To determine if the presence of lobar MBs on MRI predicts future deep ICH events.

Main Methods:

  • Prospective analysis of patients with index strokes between April 2004 and November 2009.
  • Counting nascent lobar MBs on T2*-weighted MRI scans approximately one year post-stroke and comparing with admission MRIs.
  • Utilizing Kaplan-Meier curves and multivariate logistic regression to assess deep ICH occurrence and associated risk factors.

Main Results:

  • Repeated MRIs of 508 patients revealed 157 nascent lobar MBs in 62 individuals.
  • The annual deep ICH occurrence rate was significantly higher in patients with MBs (1.9%) compared to those without (0.5%, P = .012).
  • Nascent lobar MBs were significantly associated with deep ICH recurrences (OR: 3.85, P = .020) after adjusting for hypertension, diabetes, antithrombotic drug use, white matter lesions, age, and gender.

Conclusions:

  • Lobar microbleeds may be associated with an increased risk of deep intracerebral hemorrhages.
  • Nascent lobar MBs could serve as a potential imaging biomarker for predicting deep ICHs.
Keywords:
Cerebral microbleedsintracerebral hemorrhagerecurrencerisk factorstroke

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