Cerebral Microbleeds and Future Stroke Risk: Striking the Proper Balance

Among more than 20,000 patients with cerebral ischemic events, presence of microbleeds increased risks for both future ischemic events and intracerebral hemorrhages. Should treatment change for these patients?

Cerebral microbleeds (CMs) are small (<10 mm) lesions in the brain parenchyma that are hypointense on specialized MRI sequences. Subcortical CMs may be a marker of small vessel vasculopathy; lobar CMs may indicate cerebral amyloid angiopathy (CAA). To test whether CMs increase risk for intracranial hemorrhage (ICH) in patients with a recent cerebral ischemic event, investigators assembled a large collaborative registry of 20,322 patients from 38 cohorts (mean age 70; 42% women) with documentation of CM on brain MRI who had subsequent clinical follow-up. The primary outcome was any symptomatic ICH or ischemic stroke.

Of the full group, CMs were present in 28%, close to half (43%) of whom had only one documented microbleed. During the median 1…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Cerebral Microbleeds and Future Stroke Risk: Striking the Proper Balance

Topics

Reviewing Author