Cerebral Microbleeds Are Associated With an Increased Risk of Stroke

Akoudad, Saloua; Portegies, Marileen L.P.; Koudstaal, Peter J.; Hofman, Albert; Lugt, Aad van der; Ikram, M. Arfan; Vernooij, Meike W.

doi:10.1161/circulationaha.115.016261

Cited by 204 publications

(176 citation statements)

References 31 publications

Supporting

Mentioning

165

Contrasting

Order By: Relevance

“…160 In that study, there were overall more ischemic strokes than hemorrhagic strokes in the individuals with microbleeds. The increased risks were independent of silent brain infarcts and WMHs.…”

Section: Anticoagulation and Other Medical Therapies In Patients Withmentioning

confidence: 80%

Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Smith¹,

Saposnik²,

Biessels³

et al. 2017

Stroke

318

297

View full text Add to dashboard Cite

Abstract-Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians. (Stroke. 2017;48:e44-e71.

show abstract

Section: Anticoagulation and Other Medical Therapies In Patients Withmentioning

confidence: 80%

Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Smith¹,

Saposnik²,

Biessels³

et al. 2017

Stroke

318

297

View full text Add to dashboard Cite

show abstract

“…Other studies have found that the presence of CMB, and especially multiple CMB, was associated with an increased risk of stroke, including first-ever ischemic stroke. 23,24 Presumably, the follow-up period in our study period was too short to detect an increase in stroke recurrence. Likewise, our …”

Section: Discussionmentioning

confidence: 91%

Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

Zerna

Modi

Bilston

et al. 2016

Stroke

View full text Add to dashboard Cite

Background and Purpose-Transient focal neurological episodes occur in cerebral amyloid angiopathy (CAA) and can mimic transient ischemic attack (TIA). Risk factors and outcomes of minor ischemic stroke or TIA might differ in patients with and without cerebral microbleeds (CMBs), including CAA-consistent lobar CMB. Methods-Baseline magnetic resonance imaging (MRI) was analyzed for CMBs and cortical superficial siderosis in 416 patients in the prospective computed tomography and MRI in the CATCH study (Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients). Clinical symptoms, baseline characteristics, recurrence, and 90-day modified Rankin Scale were prospectively collected. MRI white-matter hyperintensity was measured using the Fazekas scale. Results-CMBs were detected in 65 (15.6%) and cortical superficial siderosis in 11 patients (2.6%). Lobar CMBs were present in 49 (11.8% Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

show abstract

“…Multiple diseases, including traumatic brain injury (TBI) 1, 2 , stroke 3, 4 , hypertension and cerebral amyloid angiopathy (CAA) 5 require assessment of cerebral microhemorrhage (CMH) for diagnosis and / or management. However, the choice of neuroimaging technique can provide very different assessments of CMH burden.…”

Section: Introductionmentioning

confidence: 99%

Brain Injury Lesion Imaging Using Preconditioned Quantitative Susceptibility Mapping without Skull Stripping

Soman¹,

Liu

Kim³

et al. 2018

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

Background and Purpose Identifying cerebral microhemorrhage (CMH) burden can aid in the diagnosis and management of traumatic brain injury (TBI), stroke, hypertension, and cerebral amyloid angiopathy. MRI susceptibility based methods are more sensitive than CT for detecting CMH, but methods other than quantitative susceptibility mapping (QSM) provide results that vary with field strength and echo times, require additional phase maps to distinguish blood from calcification and depict CMHs as bloom artifacts. QSM provides universal quantification of tissue magnetic property without these constraints, but traditionally requires a mask (mQSM) generated by skull-stripping, which can pose challenges at tissue interphases. We evaluate the preconditioned QSM (pQSM) MRI method, which does not require skull-stripping, for improved depiction of brain parenchyma and pathology. Materials and Methods 56 subjects underwent brain MRI with 3D multi-echo GRE acquisition. MQSM images were created using a commonly used mask based QSM method and pQSM images were made using precondition based total field inversion. All images were reviewed by a neuroradiologist and a radiology resident. Results 10 subjects (18%), all with TBI, demonstrated blood products on 3D GRE. All lesions were visible on pQSM, while 6 were not visible on mQSM. 31 subjects (55%) demonstrated brain parenchyma and/or lesions which were visible on pQSM but not on mQSM. 6 subjects (11%) demonstrated pons artifacts on pQSM and mQSM, worse on pQSM. Conclusion pQSM MRI can bring the benefits of QSM imaging to clinical practice without the limitations of mQSM, especially for evaluating CMH associated pathologies, such as TBI.

show abstract

Cerebral Microbleeds Are Associated With an Increased Risk of Stroke

Cited by 204 publications

References 31 publications

Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

Brain Injury Lesion Imaging Using Preconditioned Quantitative Susceptibility Mapping without Skull Stripping

Contact Info

Product

Resources

About