Old Cerebral Hemorrhages in Cases of Multiple Lacunar Infarction Found by Magnetic Resonance Imaging

Miyashita, Kotaro; Nakamura, Masaichi; Kazui, Seiji; Sawada, Tohru

doi:10.1159/000108862

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…However, there was a possibility of false detection of large Virchow-Robin spaces 17 and old silent cerebral hemorrhage, which might not be distinguished from infarction with the use of such a low field strength of 0.1 T MRI. 18 The incidence of SCI in all subjects was 45 of 108 (42%). This incidence was similar to the results in a previous report 4 that estimated lacunae according to almost the same criteria as in our study.…”

Section: -1 2-3 50~60yomentioning

confidence: 98%

Silent cerebral infarction as a form of hypertensive target organ damage in the brain.

et al. 1992

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The incidence, number, size, and location of silent cerebral infarction on 0.1 T magnetic resonance imaging was investigated in 66 hypertensive patients (63±9 years old; mean±SD) and 42 age-matched normotensive subjects (61 ±9 years old) to determine the clinical significance of hypertension in silent cerebral infarction. Cerebrovascular risk factors and the severity of hypertensive changes in other major target organs were also investigated. The incidence of silent infarction in hypertensive patients (47%) tended to be higher than that of normotensive subjects (33%) and increased significantly with advancing age. In hypertensive patients, a significantly higher incidence of silent lesions was noted in patients with hypertensive changes in major target organs (72-73% in patients with organ involvement versus 33-39% in those without). The average number of lesions in hypertensive patients was significantly higher than that in normotensive subjects (6.0 versus 2.1), and the lesions in the hypertensive patients were more frequently detected in the brain areas supplied by perforating arteries than those in normotensive subjects (47% versus 24%). These results clearly demonstrate that silent cerebral infarction is frequently seen in Older hypertensive patients, especially when moderate hypertensive changes are noted in major target organs, and suggest that hypertensive arterial changes play a crucial role in the occurrence of silent infarction. {Hypertension 1992^0:816-820)

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Section: -1 2-3 50~60yomentioning

confidence: 98%

Silent cerebral infarction as a form of hypertensive target organ damage in the brain.

et al. 1992

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“…Finally, it should also be addressed that our results may not reflect the true distribution of SICH, since we included only symptomatic cases in this study. According to Miyashita et al, 50 old and clinically silent hemorrhages, often small in size, are frequently detected by MRI in the thalamus, putamen, and pons in patients with multiple lacunar infarction. Therefore, the incidence of SICH may be much higher than previously thought, and further studies are required to elucidate the true incidence and predilection sites of SICH.…”

Section: Discussionmentioning

confidence: 99%

Small primary intracerebral hemorrhage. Clinical presentation of 28 cases.

Kim

Lee

1994

Stroke

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Although there have been sporadic reports of patients with small intracerebral hemorrhages presenting with discrete clinical features, the clinical and distributional characteristics of these hemorrhages have not been adequately investigated. We studied 28 patients who had primary intracerebral hemorrhage of a longest diameter < or = 1.5 cm as seen in computed tomographic scan and/or magnetic resonance imaging. Small primary intracerebral hemorrhages were found in the basal ganglia in 8 patients (2 with intraventricular hemorrhage), the posterior limb of the internal capsule in 8, the area of the fourth ventricle of the cerebellum in 7 (5 with intraventricular hemorrhage), the pontine tegmentum in 4, and the thalamomesencephalic area in 1. All patients except 3 were hypertensive, suggesting that most of the hemorrhages may have occurred because of rupture of small end arteries secondary to long-standing hypertension. Depending on their location, the hemorrhages clinically manifested as pure motor stroke in 7, pure sensory stroke in 6, vertigo/ataxia in 7, sensorimotor stroke in 4, and ataxic hemiparesis in 2 patients. One patient with thalamomesencephalic hemorrhage showed vertical gaze disturbance, and 1 with basal ganglionic hemorrhage presented with symptoms of acute hydrocephalus secondary to a relatively large amount of intraventricular hemorrhage. The prognosis of small intracerebral hemorrhage was generally excellent except for when patients were very old or when there was a significant amount of intraventricular bleeding. Small primary intracerebral hemorrhage has its predilection sites: basal ganglia, posterior limb of the internal capsule, area of the fourth ventricle of the cerebellum, and pontine tegmentum. Most of the hemorrhages are probably caused by rupturing of the small end arteries in the setting of chronic hypertension. They produce discrete clinical syndromes often mimicking classic lacunar syndrome, of which pure sensory stroke is relatively common.

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“…Lacunar infarcts and hypertensive intracerebral hemorrhage occur in the same brain topographic location, within deep structures in the vascular distribution of the small perforating intracerebral arteries, including the putamen, thalamus, and pons. This suggests a similar pathophysiological process related to chronic hypertensive damage [128,129]. The Northern Manhattan Study (NOMAS) is a prospective, populationbased incidence and case follow-up study designed to determine stroke incidence, risk factors, and outcomes in a multiethnic, urban population in a well-defined area of Manhattan.…”

Section: Role Of Cholesterol In Ischemic and Hemorrhagic Strokementioning

confidence: 99%

Statins in Neurological Disorders: Mechanisms and Therapeutic Value

Reiss

Wirkowski

2009

The Scientific World JOURNAL

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Statins are well-tolerated, mainstay drugs in cardiovascular risk management. In addition to their cholesterol-lowering properties, statins also have anti-inflammatory, vasculoprotective, and antioxidant effects. They have also been associated in some epidemiologic studies with reduced risk of Alzheimer's disease (AD), and a link between cholesterol and late-onset AD has been documented. Experimental studies in cell culture systems and animal models show that statins have neuroprotective effects that may ameliorate the damage inflicted by stroke and AD. Human studies have garnered compelling evidence that treatment with statins reduces ischemic stroke incidence independent of their lipid-lowering effects. There is also the possibility that statins and extremely low cholesterol levels may increase the risk of intracranial hemorrhage. In this review, we discuss the potential reasons for the effect of statins on stroke and AD, and the multiple mechanisms of action of this class of lipid-lowering drugs.

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Old Cerebral Hemorrhages in Cases of Multiple Lacunar Infarction Found by Magnetic Resonance Imaging

Cited by 5 publications

References 16 publications

Silent cerebral infarction as a form of hypertensive target organ damage in the brain.

Silent cerebral infarction as a form of hypertensive target organ damage in the brain.

Small primary intracerebral hemorrhage. Clinical presentation of 28 cases.

Statins in Neurological Disorders: Mechanisms and Therapeutic Value

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