[Diagnosis and treatment of brain microbleeds]

Brain microbleeds (MBs) are represented as low-intensity spotty lesions on T2 *-weighted MR images and are frequently detected in healthy people and not only stroke patients. A recent meta-analysis revealed that MBs were present in 34% of patients with ischemic stroke and 60% with intracerebral hemorrhage, respectively. On the other hand, MBs only occur in approximately 4-6% of subjects without cerebrovascular disease and neurological symptoms. The occurrence of MBs in healthy elderly subjects is associated with advanced age or chronic hypertension. The pathological findings of MBs depend on the region of the brain, in which lobar and deep brain MBs are associated with cerebral amyloid angiopathy and hypertensive vasculopathy, respectively. To prevent stroke, risk factors should be carefully managed in subjects with MBs factors. Since hypertension was also found in all subjects who experienced stroke after presenting with MBs, such patients should be treated with intensive anti-hypertensive medication to prevent subsequent ischemic or hemorrhagic stroke. Additionally, antithrombotic drugs should be carefully used in patients with MBs.