Related Experiment Video

Updated: Jul 26, 2026

A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
08:12

A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage

Published on: July 28, 2018

8.5K

Brain hemorrhage recurrence, small vessel disease type, and cerebral microbleeds: A meta-analysis

Andreas Charidimou1, Toshio Imaizumi1, Solene Moulin1

  • 1From the Stroke Research Centre (A.C., Y.Y., S.M.G., H.R.J., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Hemorrhagic Stroke Research Program, Department of Neurology (A.C., A.B., E.E.S., A.V., S.M.G.), Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Degenerative & Vascular Cognitive Disorders (S.M., B.C., C.C.), Univ Lille, Inserm, CHU Lille, France; Centre for Clinical Brain Sciences (N.S., R.A.-S.S.), University of Edinburgh, UK; Department of Neurology (A.P.), Cliniques Universitaires UCL Saint Luc; Department of Neurology (Y.V., P.L.), CHU Dinant Godinne, Université Catholique de Louvain; Institute of Neuroscience (Y.V., P.L.), Université Catholique de Louvain, Brussels, Belgium; Department of Clinical Neurosciences (J.-C.B.), University of Cambridge, Addenbrooke's Hospital, UK; UMR 894 INSERM-Université Paris 5 (J.-C.B.), Sorbonne Paris Cité, Paris, France; Department of Neurology (M.H.-G., J.M.), Hospital Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Spain; Department of Neurology (D.-W.K., J.S.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Neurology (H.N.), Hiroshima Prefectural Hospital, Japan; and Hotchkiss Brain Institute (E.E.S.), University of Calgary, Canada.

Neurology
|July 28, 2017
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) on MRI indicate higher recurrent intracerebral hemorrhage (ICH) risk in survivors. Higher CMB burden and lobar distribution, especially in cerebral amyloid angiopathy-related ICH, predict increased risk.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging
  • Vascular Neurology

Background:

  • Intracerebral hemorrhage (ICH) survivors face a significant risk of recurrence.
  • Cerebral microbleeds (CMBs) on MRI are markers of underlying small vessel disease and its severity.
  • Understanding the relationship between CMBs and recurrent ICH is crucial for risk stratification.

Purpose of the Study:

  • To evaluate the risk of recurrent intracerebral hemorrhage (ICH) in ICH survivors.
  • To stratify this risk based on the presence, distribution, and number of cerebral microbleeds (CMBs) detected by MRI.
  • To assess the role of CMBs in predicting ICH recurrence, differentiating between cerebral amyloid angiopathy (CAA)-related and non-CAA ICH.

Main Methods:

  • A meta-analysis of 10 prospective cohort studies involving 1,306 patients with ICH.
  • Blood-sensitive MRI was performed soon after the initial ICH event.
  • Annualized recurrent ICH rates were estimated and compared using random effects models, analyzing CMB presence, distribution (lobar vs. non-lobar), and burden (number of CMBs).

Main Results:

  • The annual recurrent ICH risk was significantly higher in CAA-related ICH (7.4%) compared to CAA-unrelated ICH (1.1%).
  • In CAA-related ICH, multiple CMBs (≥2) were associated with increased ICH recurrence risk (ORs ranging from 3.1 to 4.3).
  • In CAA-unrelated ICH, only a high CMB burden (>10) was associated with recurrent ICH (OR 5.6); one CMB was not associated with recurrence in either group.

Conclusions:

  • CMB burden and distribution on MRI effectively identify ICH survivors at higher risk of recurrence.
  • These imaging findings can aid in predicting ICH prognosis.
  • This risk stratification has potential relevance for clinical practice and the design of future treatment trials.

More Related Videos

Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats06:39

Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats

Published on: October 17, 2018

6.9K
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

3.5K

Related Concept Videos

Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...