J Clin Neurol.  2007 Sep;3(3):147-149. 10.3988/jcn.2007.3.3.147.

Silent Microbleeds and Hemorrhagic Conversion of an Embolic Infarction

• Kim BJ
• Lee SH

• KMID: 2135493
• DOI: http://doi.org/10.3988/jcn.2007.3.3.147

Abstract

We report a patient with multiple simultaneous embolic infarctions with localized hemorrhagic conversion. A 75-year-old male patient had several silent microbleeds (SMBs) exclusively in the cerebral cortex, and underwent angioplasty and stenting for bilateral carotid stenosis. He subsequently experienced embolic infarctions in the cortex and the striatum: the cortical infarction, where an SMB had been present, showed hemorrhagic conversion, whereas the striatal infarction did not. This case suggests that SMBs are indicators of an underlying hemorrhage-prone state.

Keyword

Ischemic stroke; Stroke assessment; Microbleeds; Hemorrhage

MeSH Terms

Aged
Angioplasty
Carotid Stenosis
Cerebral Cortex
Hemorrhage
Humans
Infarction*
Male
Stents

Figure

• 

  Figure 1 Magnetic resonance imaging (MRI) obtained before (A and B) and after (C and D) balloon angioplasty and stenting performed on both carotid arteries. The gradient-echo (GRE) sequence MRI image obtained before the stenting contained two silent microbleeds (SMBs, arrowheads) in the right parietal cortex (A), but no such lesions in the deep gray matter (B). After the stenting, embolic infarctions (arrows) were simultaneously present in two areas: the left striatum and right parietal cortex (C). However, a hemorrhagic conversion (arrowhead) was identified only around the cortical stroke lesions (D) where SMBs were originally present.

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