Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

Abstract

Background:With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke.Methods:Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs.Results:Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs.Conclusions:CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

Cerebral Microbleeds: Treatment Conundrum in Acute Ischemic Stroke

“…in their study (Prevalence of cerebral microbleeds in Thai patients with ischemic stroke) published in the current issue of this journal showed that the prevalence of CMBs was 20% in the Thai population which was never reported earlier. [ 3 ] This was lower than the Japanese cohort but was at par with the published Chinese prevalence. In their study, hypertension and small vessel disease on MRI especially Fazeka stage 3 related to hypertension was associated with increased risk for CMBs.…”

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“…Potigumjon et al in their study (Prevalence of cerebral microbleeds in Thai patients with ischemic stroke) published in the current issue of this journal showed that the prevalence of CMBs was 20% in the Thai population which was never reported earlier. [3] This was lower than the Japanese cohort but was at par with the published Chinese prevalence. In their study, hypertension and small vessel disease on MRI especially Fazeka stage 3 related to hypertension was associated with increased risk for CMBs.…”

The safety of antithrombotic therapy in patients with cerebral microbleeds and cardiogenic cerebral embolism due to nonvalvular atrial fibrillation

“…Their effectiveness is comparable to that of warfarin, but the associated risk of a CH event is significantly lower than that of warfarin. Two small sample studies in Japan [4, 30] showed that NOACs do not increase the risk of new CMBs. Patients with AF and a high risk of embolism need long-term anticoagulant therapy.…”

“…The detection rate of CMBs in people over 80 years old is as high as 35.7% [3]. The incidence of CMBs in ischemic stroke patients is approximately 20% [4]. Studies have shown that CMBs not only have an important impact on hemorrhagic transformation but are also an independent risk factor for new ischemic stroke or transient ischemic attack and stroke recurrence [2–4].…”

“…The incidence of CMBs in ischemic stroke patients is approximately 20% [4]. Studies have shown that CMBs not only have an important impact on hemorrhagic transformation but are also an independent risk factor for new ischemic stroke or transient ischemic attack and stroke recurrence [2–4]. Therefore, the role of CMBs is important for the prevention and treatment of various strokes [5].…”