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Stroke. 2016 Mar;47(3):689-94. doi: 10.1161/STROKEAHA.115.011843. Epub 2016 Feb 2.

Incident Cerebral Microbleeds in a Cohort of Intracerebral Hemorrhage.

Author information

1
From the Univ. Lille, Inserm, CHU Lille, U 1171, Degenerative and vascular cognitive disorders, Lille, France, (M.P., G.B., C.R., N.D.-P., C.C.); Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille, Saint Philibert Hospital, Lille, France (M.P.); and Alzheimer Center and, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands (M.R.B.).
2
From the Univ. Lille, Inserm, CHU Lille, U 1171, Degenerative and vascular cognitive disorders, Lille, France, (M.P., G.B., C.R., N.D.-P., C.C.); Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille, Saint Philibert Hospital, Lille, France (M.P.); and Alzheimer Center and, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands (M.R.B.). charlotte.cordonnier@chru-lille.fr.

Abstract

BACKGROUND AND PURPOSE:

We aimed to identify prognostic and associated factors of incident cerebral microbleeds (CMBs) in intracerebral hemorrhage (ICH) survivors.

METHODS:

Observational prospective cohort of 168 ICH survivors who underwent 1.5T magnetic resonance imaging at ICH onset and during follow-up (median scan interval, 3.4; interquartile range, 1.4-4.7) years. We used logistic regression adjusted for age, sex, and scan interval. Analyses were stratified according to the index ICH location (58 lobar ICH, 103 nonlobar ICH, excluding patients with multiple or unclassifiable ICH).

RESULTS:

Eighty-nine (53%) patients had CMBs at ICH onset, and 80 (48%) exhibited incident CMBs during follow-up. Predictors of incident CMBs at ICH onset were ≥1 CMBs (adjusted odds ratio [aOR], 2.27; 95% confidence interval [CI], 1.18-4.35), old radiological macrohemorrhage (aOR, 6.78; 95% CI, 2.76-16.68), and CMBs in mixed location (aOR, 3.73; 95% CI, 1.67-8.31). When stratifying by ICH location, incident CMBs were associated in nonlobar ICH with incident lacunes (aOR, 2.86; 95% CI, 1.04-7.85) and with the use of antiplatelet agents (aOR, 2.89; 95% CI, 1.14-7.32). In lobar ICH, incident CMBs were associated with incident radiological macrohemorrhage (aOR, 9.76; 95% CI, 1.07-88.77).

CONCLUSIONS:

Prognostic and associated factors of incident CMBs differed according to the index ICH location. Whereas in lobar ICH, incident CMBs were associated with hemorrhagic biomarkers, in nonlobar ICH, ischemic burden also increased. CMBs may be interesting biomarkers to monitor in randomized trials on restarting antithrombotic drugs after ICH.

KEYWORDS:

antithrombotic drugs; cerebral hemorrhage; cerebral microbleeds; cohort studies; magnetic resonance imaging

PMID:
26839348
DOI:
10.1161/STROKEAHA.115.011843
[Indexed for MEDLINE]

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