Cerebral Microbleeds: Their Associated Factors, Radiologic Findings, and Clinical Implications

• Published in: Journal of stroke Vol. 15; no. 3; pp. 153 - 163
• Main Authors: Kim, Beom Joon, Lee, Seung-Hoon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Stroke Society 01.09.2013; 대한뇌졸중학회
• Subjects: antithrombotics; cerebral microbleed; gradient-echo mri; intracerebral hemorrhage; ischemic stroke; Review; 신경과학; Antithrombotics; Ischemic stroke; Gradient-echo MRI; Cerebral microbleed; Intracerebral hemorrhage
• ISSN: 2287-6391; 1229-4101; 2287-6405
• DOI: 10.5853/jos.2013.15.3.153

Cerebral microbleeds (CMBs) are tiny, round dark-signal lesions that are most often detected on gradient-echo MR images. CMBs consist of extravasations of blood components through fragile microvascular walls characterized by lipohyalinosis and surrounding macrophages. The prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke. Development of CMBs is closely related to various vascular risk factors; in particular, lobar CMBs are thought to be associated with cerebral amyloid angiopathy. The presence of CMBs has been hypothesized to reflect cerebral-hemorrhage-prone status in patients with hypertension or amyloid microangiopathy. Stroke survivors with CMBs have been consistently found to have an elevated risk of subsequent hemorrhagic stroke or an antithrombotic-related hemorrhagic complication, although studies have failed to establish a link between CMBs and hemorrhagic transformation after thrombolytic treatment. A large prospective study is required to clarify the clinical significance of CMBs and their utility in a decision-making index.