Prevalence and risk factors of cerebral microbleeds

Vernooij, Meike W.; Lugt, Aad van der; Ikram, M. Arfan; Wielopolski, Piotr A.; Niessen, Wiro J.; Hofman, Albert; Krestin, Gabriël P.; Breteler, Monique M.B.

doi:10.1212/01.wnl.0000307750.41970.d9

Cited by 747 publications

(793 citation statements)

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“…17 Cortico-subcortical areas are preferentially affected by MBs in accordance with the distribution of Aβ deposition in vascular walls in patients with CAA. [17][18][19] Deep or infratentorial MBs were positively correlated with CAApathology negative in the present study. A previous study suggested that deep or infratentorial MBs are relevant to cardiovascular risk factors, the presence of lacunar infarcts, white matter lesions, and underlying hypertension.…”

Section: Brain Images and Photomicrographs Of Evacuated Hematoma Ansupporting

confidence: 49%

Clinico-Radiological Characteristics and Pathological Diagnosis of Cerebral Amyloid Angiopathy-Related Intracerebral Hemorrhage

Doden

Sato

Sasahara

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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Objective: We aim to clarify the clinico-radiological characteristics of cerebral amyloid angiopathy-related intracerebral hemorrhage and to investigate the efficacy of pathological diagnosis using biopsy specimens. Method: We retrospectively reviewed 253 consecutive patients with cortico-subcortical hemorrhage who had been admitted to Aizawa Hospital between January 2006 and July 2013. We had performed craniotomy and hematoma evacuation in 48 patients, as well as biopsy of the evacuated hematoma, cerebral parenchyma adjacent to the hematoma, or both, and they were classified according to the histological results (positive or negative for vascular amyloid deposition) and to the Boston criteria. We compared the clinicoradiological characteristics of cerebral amyloid angiopathy-related intracerebral hemorrhage. We also investigated the detection rate of cerebral amyloid angiopathy with respect to the origins of the specimens. Results: Pathological examination revealed that 22 subjects were positive for vascular amyloid. The number of the cerebral microbleeds located in the deep or infratentorial region was significantly larger in the negative group than in the positive group (P < .05). There was no significant difference in the distribution of lobar cerebral microbleeds and in the prevalence of hypertension. In the probable cerebral amyloid angiopathyrelated intracerebral hemorrhage patients, the probability of having vascular amyloid detected by biopsy of both hematoma and parenchyma was 100%. Rebleeding in the postoperative periods was observed in 2 cases (9.1%) of the positive group.Conclusions: Our results demonstrate the importance and safety of biopsy simultaneously performed with hematoma evacuation. Deep or infratentorial microbleeds are less correlated with cerebral amyloid angiopathy-related intracerebral hemorrhage than with noncerebral amyloid angiopathy-related intracerebral hemorrhage.

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Section: Brain Images and Photomicrographs Of Evacuated Hematoma Ansupporting

confidence: 49%

Clinico-Radiological Characteristics and Pathological Diagnosis of Cerebral Amyloid Angiopathy-Related Intracerebral Hemorrhage

Doden

Sato

Sasahara

et al. 2016

Journal of Stroke and Cerebrovascular Diseases

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“…ICH can be divided into primary ICH (PICH) and secondary ICH. PICH accounts for 78%-88% of ICH cases and is mainly caused by chronic hypertension and spontaneous small vessel rupture due to amyloid angiopathy (CAA) [94] .…”

Section: Hemorrhagic Strokementioning

confidence: 99%

Genetics of stroke

Guo

Liu

2010

Acta Pharmacol Sin

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Stroke is the second most common cause of death and the most common cause of disability in developed countries. Stroke is a multifactorial disease caused by a combination of environmental and genetic factors. Numerous epidemiologic studies have documented a significant genetic component in the occurrence of strokes. Genes encoding products involved in lipid metabolism, thrombosis, and inflammation are believed to be potential genetic factors for stroke. Although a large group of candidate genes have been studied, most of the epidemiological results are conflicting. Studies of stroke as a monogenic disease have made huge progress, and animal models serve as an indispensable tool to dissect the complex genetics of stroke. In the present review, we provide insight into the role of in vivo stroke models for the study of stroke genetics.

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“…The differences in age and disease prevalence between earlier studies and ours may have also influenced these results. Indeed, incidence of CMBs increases with age (Vernooij et al., 2008). In addition, the prevalence and number of CMB are relatively high in patients with AD, MCI, and VaD (Cordonnier et al., 2006; Shams et al., 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Strictly lobar CMBs (SL‐CMBs) are thought to be caused by cerebral amyloid angiopathy (CAA) frequently in patients with Alzheimer's disease (AD), whereas nonlobar CMBs (deep or infratentorial) are thought to be due to hypertensive vasculopathy (HV) (Greenberg et al., 2009; van Rooden et al., 2009). Mixed (deep/infratentorial with lobar) CMBs (M‐CMBs) are also thought to reflect HV (Greenberg et al., 2009; Vernooij et al., 2008). HV and CAA may synergistically contribute to the development of lobar CMBs (Cordonnier & van der Flier, 2011; Fazekas et al., 1999; Kim et al., 2016; Lee, Kim, Kim, Yoon, & Roh, 2007; Park et al., 2013; Smith et al., 2010).…”

Section: Introductionmentioning

confidence: 99%

Background and distribution of lobar microbleeds in cognitive dysfunction

et al. 2017

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ObjectivesCerebral microbleeds (CMBs) are often observed in memory clinic patients. It has been generally accepted that deep CMBs (D‐CMBs) result from hypertensive vasculopathy (HV), whereas strictly lobar CMBs (SL‐CMBs) result from cerebral amyloid angiopathy (CAA) which frequently coexists with Alzheimer's disease (AD). Mixed CMBs (M‐CMBs) have been partially attributed to HV and also partially attributed to CAA. The aim of this study was to elucidate the differences between SL‐CMBs and M‐CMBs in terms of clinical features and regional distribution.MaterialsWe examined 176 sequential patients in our memory clinic for clinical features and CMB location using susceptibility‐weighted images obtained on a 3T‐MRI. The number of lobar CMBs in SL‐CMBs and M‐CMBs was counted in each cerebral lobe and their regional density was adjusted according to the volume of each lobe.ResultsOf the total 176 patients, 111 patients (63.1%) had CMBs. Within the patients who had CMBs, M‐CMBs were found in 54 patients (48.6%), followed by SL‐CMBs in 35 (31.5%) and D‐CMBs in 19 (17.1%). The SL‐CMB group showed a significantly higher prevalence of family history of dementia, whereas the M‐CMB group showed an increasing trend toward hypertension and smoking. The prevalence of AD was significantly higher in the SL‐CMBs group, whereas the prevalence of AD with cerebrovascular disease was higher in the M‐CMBs group. The regional density of lobar CMBs was significantly higher in the occipital lobe in the M‐CMB group, whereas the SL‐CMB group showed higher regional density between regions an increasing tendency in the parietal and occipital lobe.ConclusionThe between‐group differences in clinical features and regional distribution indicate there to be an etiological relationship of SL‐CMBs to AD and CAA, and M‐CMBs to both HV and CAA.

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Prevalence and risk factors of cerebral microbleeds

Abstract: The prevalence of cerebral microbleeds is high. Our data support the hypothesis that strictly lobar microbleeds are related to cerebral amyloid angiopathy, whereas microbleeds in a deep or infratentorial location result from hypertensive or atherosclerotic microangiopathy.

Cited by 747 publications

References 38 publications

Clinico-Radiological Characteristics and Pathological Diagnosis of Cerebral Amyloid Angiopathy-Related Intracerebral Hemorrhage

Clinico-Radiological Characteristics and Pathological Diagnosis of Cerebral Amyloid Angiopathy-Related Intracerebral Hemorrhage

Genetics of stroke

Background and distribution of lobar microbleeds in cognitive dysfunction

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