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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
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Cerebral microbleeds: Causes, clinical relevance, and imaging approach - A narrative review

Amit Agarwal1, Pranav Ajmera2, Preetika Sharma1

  • 1Department of Radiology, Mayo Clinic, Jacksonville, United States.

Journal of Neurosciences in Rural Practice
|May 15, 2024
PubMed

Insights

Cerebral microhemorrhages, identified by MRI, are increasingly detected, especially in older adults. Understanding their causes and clinical impact is crucial for stroke prognosis.

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Microhemorrhages are increasingly identified with advanced MRI sequences, particularly in older populations.
  • Defined as small signal loss areas on gradient echo MRI, they represent hemosiderin deposition with diverse causes.
  • Susceptibility-weighted imaging (SWI) enhances microhemorrhage detection.

Purpose of the Study:

  • To review the pathophysiology, prevalence, and clinical significance of cerebral microhemorrhages.
  • To discuss the prognostic value of microbleeds in stroke.
  • To briefly cover technical aspects of SWI for microhemorrhage detection.

Main Methods:

  • Review of current literature on cerebral microhemorrhages.
  • Focus on gradient echo MRI sequences, specifically SWI.
  • Analysis of etiologies, prevalence across age groups, and clinical implications.

Main Results:

  • Microhemorrhages are common, with prevalence increasing with age.
  • Cerebral amyloid angiopathy and hypertension are leading causes in peripheral and central patterns, respectively.
  • In younger individuals, familial conditions and hypercoagulable states are more frequent causes.

Conclusions:

  • Microhemorrhages have significant clinical implications, especially for stroke prognosis.
  • SWI is a vital tool for identifying these lesions.
  • Further understanding of microhemorrhage pathophysiology and clinical impact is warranted.
Keywords:
CerebralHemorrhageMagnetic resonance imagingMicrobleedSusceptibility

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