BACKGROUND AND PURPOSE: We studied the risk of recurrent cerebrovascular events in patients who had a transient ischemic attack or ischemic stroke and who had evidence of microbleeds on MRI. METHODS: A prospective follow-up study was performed on hospitalized patients who were at least 50 years old with a transient ischemic attack or an ischemic stroke. The presence and number of microbleeds were assessed on gradient echo MRI and the presence of white matter disease on fluid-attenuated inversion recovery imaging using a semiquantitative scale. Patients were followed up by phone every 6 months. End points were intracerebral hemorrhage, ischemic stroke, and unclassified stroke. Cerebral events were adjudicated by 2 independent neurologists blinded to the presence of microbleeds. Cox regression analysis was performed. RESULTS: A total of 487 patients with a mean age of 72 years were followed up for a median of 2.2 years (25th to 75th percentile 1.9 to 2.7 years). Microbleeds were identified in 129 patients (25.6%). Two patients developed intracerebral hemorrhage during follow-up, 32 patients developed recurrent ischemic stroke, and 3 patients had unclassified strokes. Microbleeds were not independent predictors of recurrent stroke (P=0.2) or intracerebral hemorrhage (P=0.43). Lobar microbleeds or combined lobar and deep microbleeds were independently associated with recurrent stroke (P=0.018). CONCLUSIONS: In this European cohort, patients with microbleeds who have had cerebral ischemia have a higher risk of developing new ischemic strokes than of intracerebral hemorrhage. Lobar microbleeds or combined lobar and deep microbleeds might be independent predictors of recurrent stroke.
BACKGROUND AND PURPOSE: We studied the risk of recurrent cerebrovascular events in patients who had a transient ischemic attack or ischemic stroke and who had evidence of microbleeds on MRI. METHODS: A prospective follow-up study was performed on hospitalized patients who were at least 50 years old with a transient ischemic attack or an ischemic stroke. The presence and number of microbleeds were assessed on gradient echo MRI and the presence of white matter disease on fluid-attenuated inversion recovery imaging using a semiquantitative scale. Patients were followed up by phone every 6 months. End points were intracerebral hemorrhage, ischemic stroke, and unclassified stroke. Cerebral events were adjudicated by 2 independent neurologists blinded to the presence of microbleeds. Cox regression analysis was performed. RESULTS: A total of 487 patients with a mean age of 72 years were followed up for a median of 2.2 years (25th to 75th percentile 1.9 to 2.7 years). Microbleeds were identified in 129 patients (25.6%). Two patients developed intracerebral hemorrhage during follow-up, 32 patients developed recurrent ischemic stroke, and 3 patients had unclassified strokes. Microbleeds were not independent predictors of recurrent stroke (P=0.2) or intracerebral hemorrhage (P=0.43). Lobar microbleeds or combined lobar and deep microbleeds were independently associated with recurrent stroke (P=0.018). CONCLUSIONS: In this European cohort, patients with microbleeds who have had cerebral ischemia have a higher risk of developing new ischemic strokes than of intracerebral hemorrhage. Lobar microbleeds or combined lobar and deep microbleeds might be independent predictors of recurrent stroke.
Authors: Anne F Wiegman; Irene B Meier; Nicole Schupf; Jennifer J Manly; Vanessa A Guzman; Atul Narkhede; Yaakov Stern; Sergi Martinez-Ramirez; Anand Viswanathan; José A Luchsinger; Steven M Greenberg; Richard Mayeux; Adam M Brickman Journal: J Neurol Sci Date: 2014-07-18 Impact factor: 3.181
Authors: Andreas Charidimou; Sara Shams; Jose R Romero; Jie Ding; Roland Veltkamp; Solveig Horstmann; Gudny Eiriksdottir; Mark A van Buchem; Vilmundur Gudnason; Jayandra J Himali; M Edip Gurol; Anand Viswanathan; Toshio Imaizumi; Meike W Vernooij; Sudha Seshadri; Steven M Greenberg; Oscar R Benavente; Lenore J Launer; Ashkan Shoamanesh Journal: Int J Stroke Date: 2018-01-17 Impact factor: 5.266