Susceptibility Etching on MRI in Patients with Microangiopathy

Chang, Jennifer; Arani, Keerthi; Chew, Sheena; Frosch, Matthew P.; González, Ramón; Maza, Noor; Romero, Javier

doi:10.1111/jon.12384

Cited by 5 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Cerebral microbleeds have been also reported in septic shock patients with or without DIC and/or cardiac arrest. [14][15][16] Despite similar locations, microbleeds in these patients with microangiopathies were responsible for both white and grey matter damage, thalami and dentate nuclei impairment, contrasting with our poisoned patients. Histopathological data found microscopic infarctions in the splenium of the corpus callosum caused by thrombosis or embolism but not haemorrhages, highlighting the contribution of microangiopathy.…”

Section: Subcortical White Mattercontrasting

confidence: 65%

See 1 more Smart Citation

Cerebral microbleeds in the poisoned patient: An observational magnetic resonance imaging study

Naïm,

Malissin,

Mégarbane

2023

Basic Clin Pharma Tox

View full text Add to dashboard Cite

Critical illness‐associated cerebral microbleeds of poorly understood pathophysiology have been observed on magnetic resonance imaging (MRI) in severely hypoxemic patients similarly to high‐altitude cerebral edema patients. The prevalence and circumstances of occurrence of such cerebral microbleeds in the severely poisoned patients is unknown. We retrospectively reviewed all cerebral MRIs performed in the poisoned patients with atypical neurological presentation or outcome admitted to our intensive care unit in 2014‐2021. Three out of 64 patients (4.7%) investigated with cerebral MRI among the 2,986 severely poisoned patients presented cerebral microbleeds. Microbleeds were localized in the white cerebral matter mainly in the corpus callosum. Ingested toxicants included dichlorvos, methadone and tramadol. Patients were found comatose with possibly prolonged severe hypoxemia requiring prompt tracheal intubation and mechanical ventilation. They presented delayed arousal and dysexecutive syndrome leading to sequelae. Microbleeds on MRI can occur in the critically ill poisoned patients and seems to be a multifactorial phenomenon. A direct relationship with the toxicant seems improbable. Physicians should be aware of such a non‐specific complication accounting for sequelae.

show abstract

Section: Subcortical White Mattercontrasting

confidence: 65%

“…Cerebral microbleeds have been also reported in septic shock patients with or without DIC and/or cardiac arrest 14–16 . Despite similar locations, microbleeds in these patients with microangiopathies were responsible for both white and grey matter damage, thalami and dentate nuclei impairment, contrasting with our poisoned patients.…”

Section: Discussionmentioning

confidence: 44%

Cerebral microbleeds in the poisoned patient: An observational magnetic resonance imaging study

Naïm,

Malissin,

Mégarbane

2023

Basic Clin Pharma Tox

View full text Add to dashboard Cite

show abstract

“…The authors suggested an association of endothelial dysfunction, DIC and thrombotic microangiopathy as a common potential cause of MH in critically ill patients. 30 In our study and across all similar COVID-19 case series published to date, there was evidence of coagulopathy, but no patients met international consensus criteria for overt DIC. 4 14 31 This aligns with a recent study that suggests that COVID-19 coagulopathy is distinct from DIC.…”

Section: Discussionmentioning

confidence: 47%

Cerebral microhaemorrhage in COVID-19: a critical illness related phenomenon?

et al. 2020

View full text Add to dashboard Cite

BackgroundCerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.MethodsA retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients’ baseline characteristics and salient test results were also recorded.ResultsCerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.DiscussionThis study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.

show abstract

“…This is supported by the relatively low rate of macroscopic hemorrhages in our study and previous studies (2,12,13), despite routine use of anticoagulation/antiplatelet treatment in COVID-19. Interestingly, hemorrhagic components are not always histopathologically evident in critically ill patients with SWI abnormalities either (33). The terminology may affect the clinical cost-benefit analysis of anticoagulation therapy and since microthrombi is a valid differential diagnosis, this semantic issue is of clinical importance.…”

Section: Discussionmentioning

confidence: 99%