J Stroke.  2013 Sep;15(3):153-163.

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

• Kim BJ
• Lee SH

Abstract

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.

Keyword

Cerebral microbleed; Ischemic stroke; Intracerebral hemorrhage; Antithrombotics; Gradient-echo MRI

MeSH Terms

Aged
Aluminum Hydroxide
Amyloid
Carbonates
Cerebral Amyloid Angiopathy
Cerebral Hemorrhage
Humans
Hypertension
Macrophages
Prevalence
Stroke
Survivors
Aluminum Hydroxide
Amyloid
Carbonates