S. H. Lee, MD, H. J. Bae, MD, S. J. Kwon, MD, H. Kim, PhD, Y. H. Kim, MPH, B. W. Yoon, MD PhD and J. K. Roh, MD PhD
From the Department of Neurology (Drs. Lee, Kwon, Yoon, and Roh), Seoul National University, and Neuroscience Research Institute, SNUMRC, and Clinical Research Institute, Seoul National University Hospital, Department of Neurology (Dr. Bae), Eulji Medical Center, and Department of Epidemiology and Biostatistics and Institute of Public Health (Dr. Kim), School of Public Health, Seoul National University, Korea.
Address correspondence and reprint requests to Dr. J.-K Roh, Department of Neurology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
Background: Cerebral microbleeds (CMB) may be indicative of a hemorrhage-prone microangiopathy.
Objective: To determine if increased numbers of these lesions are predictive of intracerebral hemorrhage (ICH), especially in terms of a distributional association.
Methods: The authors examined consecutively 227 patients with acute stroke. CMB were counted using T2*-weighted gradient echo MRI data, and old lacunes and leukoaraiosis were also evaluated. The associations between the vascular risk factors and ICH were analyzed. With use of multivariate logistic regression analysis, the locations of the CMB or the old lacunes, which were categorized as being in the corticosubcortical area, the deep gray matter area, or the infratentorial area, were examined with regard to their relationships to the locations of the ICH.
Results: The degrees of the CMB (r = 0.43, p < 0.01) and leukoaraiosis (r = 0.20, p < 0.01) were well correlated with the presence of ICH. Multivariate analysis revealed that the grades of the CMB were associated with the presence of ICH (p < 0.01, odds ratio [OR] = 2.67). CMB in the corticosubcortical area (p < 0.01, OR = 5.50) or deep gray matter (p < 0.01, OR = 2.55) were strongly associated with the presence of ICH in the same area, but no such association was observed in the case of CMB in the infratentorial area or in the case of old lacunes in any area.
Conclusions: Cerebral microbleeds are strongly associated with the presence of intracerebral hemorrhage, and the distributional associations are also quite strong.