This Article Full Text Full Text (PDF) All Versions of this Article: 37/3/911    most recent 01.STR.0000204237.66466.5fv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boulanger, J.-M. Search for Related Content PubMed PubMed Citation Articles by Boulanger, J.-M. Pubmed/NCBI databases Medline Plus Health Information Stroke Transient Ischemic Attack Related Collections Transient Ischemic Attacks Acute Cerebral Infarction Computerized tomography and Magnetic Resonance Imaging Intracerebral Hemorrhage

(Stroke. 2006;37:911.)
© 2006 American Heart Association, Inc.

Research Report

Cerebral Microhemorrhages Predict New Disabling or Fatal Strokes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack

Jean-Martin Boulanger, MD; Shelagh B. Coutts, MD; Michael Eliasziw, PhD; A.J. Gagnon, MD; Jessica E. Simon, MBChB; Suresh Subramaniam, MD; Chul-Ho Sohn, MD; James Scott, MD; Andrew M. Demchuk, MD for the VISION Study Group

From the Seaman Family MR Research Centre (J.-M.B., S.B.C., A.J.G., J.E.S., S.S., C.-H.S., J.S., A.M.D.), Foothills Medical Centre, Calgary Health Region, Canada; Departments of Clinical Neurosciences (J.-M.B., S.B.C., M.E., A.J.G., J.E.S., S.S., A.M.D.), Community Health Sciences (M.E.), Medicine (J.E.S.), and Radiology (J.S.), University of Calgary, Canada; and Department of Radiology (C.-H.S.), Keimyung University, South Korea.

Correspondence to Dr Jean-Martin Boulanger, Clinique Neuro Rive-Sud, 4896 Blvd Taschereau 250, Greenfield Park, Provinvr of Quebec, Canada, J4V 2J2. E-mail jbouboul{at}hotmail.com

Background and Purpose— Cerebral microhemorrhages (MHs) are common among patients presenting with acute ischemic stroke and may predict both subsequent ischemic and hemorrhagic strokes.

Methods— We prospectively studied patients with and without MHs presenting within 12 hours of their ischemic stroke or transient ischemic attack (TIA). A magnetic resonance (MR) scan was performed within 24 hours of symptom(s) onset. The primary outcome was disabling or fatal stroke at 18 months.

Results— An MR scan was done in 236 patients with acute ischemic stroke or TIA. Forty-five (19.1%) patients had an MH on a baseline MR scan. Patients with MHs were 2.8x (10.8% versus 4.0%; P=0.036) more likely to have a subsequent disabling or fatal stroke than patients without an MH. The risk of symptomatic intracerebral hemorrhage was not statistically significant among MH and non-MH patients (3.3% versus 0.8%; P=0.31).

Conclusions— The presence of cerebral MH(s) in patients with acute ischemic stroke or TIA predicts recurrent disabling and fatal strokes. This risk is mainly assumed by recurrent ischemic strokes.

Key Words: cerebral infarction • intracerebral hemorrhage • magnetic resonance imaging

This article has been cited by other articles:

				L. H.G. Henskens, R. J. van Oostenbrugge, A. A. Kroon, P. W. de Leeuw, and J. Lodder Brain Microbleeds Are Associated With Ambulatory Blood Pressure Levels in a Hypertensive Population Hypertension, January 1, 2008; 51(1): 62 - 68. [Abstract] [Full Text] [PDF]

				C. Cordonnier, R. Al-Shahi Salman, and J. Wardlaw Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting Brain, August 1, 2007; 130(8): 1988 - 2003. [Abstract] [Full Text] [PDF]

				J. S. Jeret, C . Cordonnier, W .M. van der Flier, J .D. Sluimer, F . Barkhof, and P . Scheltens Prevalence and severity of microbleeds in a memory clinic setting Neurology, January 30, 2007; 68(5): 391 - 391. [Full Text] [PDF]

				H. H. Dib, S. Y. Hong, Z. Bin, and S. Hongliang Health Care Costs in China: Need for Intervention Journal of Health Management, January 1, 2007; 9(1): 85 - 103. [Abstract] [PDF]