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Acute Microbleeds and Microinfarcts Within the Perihematomal Area After Intracerebral Hemorrhage

Laurent Puy1, Antoine Rauch1,2, Vincent Deramecourt1,3

  • 1Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France (L.P., A.R., V.D., C.C., V.B.).

Stroke
|February 13, 2023
PubMed
Abstract

Insights

Spontaneous intracerebral hemorrhage (ICH) is associated with acute microbleeds and microinfarcts in the surrounding brain tissue. These microvascular lesions, alongside systemic inflammation, may contribute to secondary brain damage after ICH.

Area of Science:

  • Neuropathology
  • Neuroscience
  • Vascular Biology

Background:

  • Spontaneous intracerebral hemorrhage (ICH) pathophysiology requires further understanding.
  • Acute microvascular lesions, including microbleeds and microinfarcts, are implicated in secondary brain injury.
  • Examining the perihematomal area is crucial for identifying these lesions.

Purpose of the Study:

  • To investigate the presence and characteristics of acute microvascular lesions in the perihematomal area of ICH patients.
  • To analyze the association between these lesions and systemic inflammatory responses.
  • To elucidate the role of microbleeds and microinfarcts in ICH-related brain damage.

Main Methods:

  • Postmortem neuropathological examination of brain tissue from 14 ICH patients (died within one month of ICH).
  • Analysis of paraffin-embedded sections from the perihematomal area using various stainings and immunolabelings.
  • Characterization of microbleeds, microinfarcts, and surrounding neuronal and inflammatory reactions (macrophages, neutrophils).

Main Results:

  • Acute microbleeds were found in 86% of patients, and microinfarcts in 36%.
  • Microbleeds were present regardless of the time from ICH onset to death.
  • Microinfarcts were predominantly observed between days 3 and 7 post-ICH.
  • Both lesion types showed significant accumulation of systemic inflammatory cells and necrotic areas.

Conclusions:

  • Acute microbleeds and microinfarcts in the perihematomal area may worsen secondary brain tissue damage after ICH.
  • The recruitment of systemic inflammatory cells might play a significant role in the development of these microvascular injuries.
  • Further research is needed to explore therapeutic strategies targeting microvascular damage and inflammation in ICH.
Keywords:
edemainflammationintracerebral hemorrhagemicrobleedsmicroinfarcts

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