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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Underlying embolic and pathologic differentiation by cerebral microbleeds in cryptogenic stroke.

Muneaki Kikuno1,2, Yuji Ueno3, Takahiro Shimizu4

  • 1Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.

Journal of Neurology
|February 5, 2020
PubMed
Summary

Cerebral microbleeds (CMBs) are common in cryptogenic stroke. Age, male sex, hypertension, kidney disease, and white matter disease are associated with CMBs, with specific links to aortic lesions and anticoagulant therapy.

Keywords:
Aortic complicated lesionCerebral microbleedsCryptogenic strokeEmbolic stroke of undetermined sourceTransesophageal echocardiography

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Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Research

Background:

  • Cryptogenic stroke has diverse causes, and cerebral microbleeds (CMBs) present differently across stroke subtypes.
  • The relationship between CMBs and cryptogenic stroke remains largely unexplored.

Purpose of the Study:

  • To investigate the prevalence and clinical associations of CMBs in patients with cryptogenic stroke.
  • To identify factors associated with the presence and location of CMBs in this population.

Main Methods:

  • Utilized the CHALLENGE ESUS/CS multicenter registry, including gradient-echo T2*-weighted MRI.
  • Compared clinical characteristics of cryptogenic stroke patients based on the presence and location of CMBs.

Main Results:

  • 32% of 661 patients had CMBs. Independent predictors included older age, male sex, hypertension, chronic kidney disease, and white matter hyperintensities.
  • Aortic complicated lesions correlated with deep/diffuse CMBs; prior anticoagulant therapy was linked to lobar CMBs.

Conclusions:

  • CMBs are frequent in cryptogenic stroke and associated with several clinical factors.
  • Specific associations were found between CMB location and aortic lesions or prior anticoagulant use.