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Incident Cerebral Microbleeds After Intracerebral Hemorrhage

Luke A Perry1, Mark Rodrigues1, Rustam Al-Shahi Salman1

  • 1From the Centre for Clinical Brain Sciences (CCBS), University of Edinburgh.

Stroke
|June 18, 2019
PubMed

Insights

Approximately 40% of patients develop new cerebral microbleeds (CMB) after intracerebral hemorrhage (ICH). Incident CMB may increase the risk of recurrent lobar ICH, but further research is needed for other outcomes.

Area of Science:

  • Neurology
  • Radiology
  • Public Health

Background:

  • Cerebral microbleeds (CMB) are small spots of bleeding in the brain.
  • The frequency and impact of new CMB after intracerebral hemorrhage (ICH) are not well understood.

Purpose of the Study:

  • To determine the frequency of incident CMB after ICH.
  • To investigate the prognostic implications of incident CMB for clinical outcomes.

Main Methods:

  • Systematic review and meta-analysis of longitudinal studies.
  • Searched Ovid Medline and Embase for studies with repeated brain MRI after ICH.
  • Included 4 cohort studies with 349 patients.

Main Results:

  • The pooled proportion of patients with at least one new CMB was approximately 40% (95% CI, 30%-50%) after a mean follow-up of 27 months.
  • Increased number of incident CMB was associated with a higher risk of recurrent symptomatic lobar ICH (HR 3.0; 95% CI, 1.2-7.3).
  • No studies reported on incident ischemic stroke or death.

Conclusions:

  • Incident CMB are common after ICH, occurring in about 40% of patients.
  • The association between incident CMB and recurrent lobar ICH requires further confirmation.
  • The impact of incident CMB on death and ischemic stroke needs investigation.
Keywords:
braincerebral hemorrhagemagnetic resonance imagingmeta-analysisreview

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