Old Microbleeds Are a Potential Risk Factor for Cerebral Bleeding After Ischemic Stroke
| Autor: | Norbert Nighoghossian, J.F. Dugor, Jean-Claude Froment, P. Adeleine, P. Trouillas, K. Blanc-Lasserre, J. Honnorat, Frédéric Philippeau, Laurent Derex, Marc Hermier |
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| Rok vydání: | 2002 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty medicine.diagnostic_test business.industry Cerebral infarction Microangiopathy Ischemia Magnetic resonance imaging medicine.disease Magnetic resonance angiography Central nervous system disease Angiography medicine Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business Stroke |
| Zdroj: | Stroke. 33:735-742 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose — T2*-weighted gradient-echo MRI is known to detect old microbleeds (MBs), considered indicative of microangiopathy. MBs might be a potential risk factor for early cerebral bleeding (CB) after ischemic stroke. Therefore, we assessed the impact of MBs on the occurrence of CB after cerebral infarction. Methods — We included prospectively stroke patients who had documented ischemic damage. The imaging protocol involved baseline CT scan, T2*-weighted gradient-echo MRI, diffusion-weighted imaging, T2-weighted imaging, and magnetic resonance angiography and had to be performed within 24 hours after symptom onset. The assessment of CB with T2*-weighted gradient-echo sequence necessitated a focal area of signal loss either within the ischemic area revealed by diffusion-weighted imaging or remote from it. Old MBs were defined on T2*-weighted images as homogeneous rounded areas of signal loss without surrounding edema. CT scan was systematically repeated within the first week to verify CB as diagnosed by the T2* weighted sequence. Results — One hundred patients (mean age, 60±13 years; range, 19 to 83 years; 58 men, 42 women) met the inclusion criteria. MBs were seen in 20 patients on T2*-weighted imaging. Multivariate logistic regression analysis revealed that age, diabetes, previous use of antithrombotic drugs, evidence of an atherothrombotic source of stroke, and lacunar infarct were significantly associated with MBs ( P P Conclusions — Although the pathogenesis of CB after ischemic stroke is multifactorial, the increased observation of CB in patients with MBs suggests that the associated vascular vulnerability contributes to CB. |
| Databáze: | OpenAIRE |
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