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(Stroke. 2007;38:1730.)
© 2007 American Heart Association, Inc.

Editorials

Brain Microbleeds and Cognitive Function

Julie A. Schneider, MD, MS

From the Rush Alzheimer’s Disease Center, Department of Pathology and Neurological Sciences, Rush University Medical Center, Chicago, Ill.

Correspondence to Julie A. Schneider, MD, Rush Alzheimer’s Disease Center, 600 S. Paulina St, AAC, Suite 1022F, Chicago, IL 60612. E-mail Julie_A_Schneider@rush.edu

Key Words: brain imaging • cognition • microbleeds

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There has been increasing recognition of the role of cerebrovascular disease and its risk factors in the etiopathogenesis of dementia in older persons.^1,2 Cerebral infarcts, white matter changes, hypertension, and diabetes have all been implicated as causal agents or risk factors for dementia.³ The public health impact of cerebrovascular disease on dementia is underscored by the observation that up to one third of older individuals have cerebral infarcts by neuroimaging⁴ or pathology,⁵ many without clinically recognized stroke.^4–6 These infarcts, often subcortical in location,^4–6 not only can result in dementia,⁷ but may also add to cognitive impairment,⁵ lower the threshold for dementia,⁸ and have a synergistic effect with Alzheimer disease pathology.⁹ Subcortical infarcts are most often secondary to small vessel disease, pathologically identified by lipohyalinosis of the straight penetrating arterioles. Hypertension and diabetes are both risk factors for this pathology and thereby risk factors for subcortical infarcts. Vessel wall changes can lead to hemorrhage as well as infarction. When the leakiness of blood vessels results in small amounts of extravasated blood and ultimately hemosiderin, this is known as microbleeds. Microbleeds are defined as small hemorrhages recognized by their small round homogenous low signal appearance on gradient-echo T2* MRI. In addition to their association with small vessel disease, microbleeds have also been pathologically linked with amyloid angiopathy.^10,11 Clinically, microbleeds have been associated with cerebrovascular disease and some of its risk factors, including lacunar infarcts, hemorrhages, white matter changes, and hypertension.¹² Microbleeds have also been reported to be increased in Binswanger disease,¹³ mild . . . [Full Text of this Article]

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