Significance of haemorrhagic lacunes on MRI in patients with hypertensive cerebrovascular disease and intracerebral haemorrhage

Scharf, Johann; Bräuherr, E; Forsting, Michael; Sartor, Klaus

doi:10.1007/bf00593508

Cited by 60 publications

(36 citation statements)

References 31 publications

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“…4,12,13 Third, studies showed that patients with ICH had a higher frequency of microhemorrhages than those without ICH. 3,4 Therefore, the topographical similarity between hPMH and PPH may provide another clue that primary microhemorrhages could predispose to ICH and that hPMH may be a risk factor for future symptomatic and potentially catastrophic PPH.…”

Section: Discussionmentioning

confidence: 99%

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Hypertensive Pontine Microhemorrhage

Jeong

Yoon

Kang

et al. 2002

Stroke

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Background and Purpose — This study investigated whether the topography of hypertensive pontine microhemorrhages (hPMHs) resembles that of larger primary pontine hemorrhages. Methods — Sixty-nine consecutive patients with small-vessel disease underwent imaging with gradient-echo MRI, and 27 patients with hPMH were detected. Lesion size and location along the rostrocaudal (longitudinal), lateral (coronal), and anteroposterior (sagittal) axes were determined. Results — A total of 52 hPMHs were identified in the 27 patients (mean, 1.93±2.4 per patient). The lesions showed a nonrandom distribution, with a propensity to occur in the middle pons in the rostrocaudal axis, posterior half of the basis pontis in the anteroposterior axis, and central subdivision within the lateral axis. The area of hPMH ranged from 1.3 to 19.0 mm 2 (mean, 5.06±3.72 mm 2 ). The size of hPMH did not vary as a function of lesion location. Conclusions — Previous studies reported that primary pontine hemorrhages tend to occur in the middle pons and at the junction of basis pontis and tegmentum. Therefore, topographical correspondences between large and small pontine hemorrhages may provide evidence that the 2 lesions share some etiological basis. Further investigation may determine whether hPMHs portend future symptomatic primary pontine hemorrhages.

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Section: Discussionmentioning

confidence: 99%

“…1,2 Some studies suggested that microhemorrhage associated with hypertension could precede catastrophic intracranial hemorrhage (ICH). [2][3][4] However, few studies have compared the anatomic distributions of large ICHs and microhemorrhages.…”

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confidence: 99%

Hypertensive Pontine Microhemorrhage

Jeong

Yoon

Kang

et al. 2002

Stroke

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“…Earlier investigations that have reported a smaller rate of MBs in association with ICH have used conventional MRI sequences in all or most of their patients. 2,12 Therefore, these lower numbers most likely resulted from the inferior sensitivity of conventional T2-weighted scans in the detection of small hemosiderin deposits. A much higher detection rate of MBs has recently been documented with the use of a gradient-echo technique compared with conventional T2 sequences in a direct comparison.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Location of Microbleeds in Patients With Primary Intracerebral Hemorrhage

Roob

Lechner

Schmidt

et al. 2000

Stroke

199

164

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Background and Purpose-MRI is known to detect clinically silent microbleeds (MBs) in patients with primary intracerebral hemorrhage (pICH), but the frequency and diagnostic and clinical significance of this finding are still debated. Therefore, we investigated a consecutive series of pICH patients and analyzed the patterns of MB distribution in the context of clinical variables and location of the symptomatic hematoma. Methods-The study population consisted of 109 patients with pICH. There were 59 women and 50 men aged 22 to 91 years (mean 64.6 years). MRI was obtained on a 1.5-T system with use of a gradient-echo T2*-weighted sequence. A cohort of 280 community-dwelling asymptomatic elderly individuals who underwent the same imaging protocol served for comparison. Results-MBs were seen in 59 (54%) patients and ranged in number from 1 to 90 lesions (mean 14, median 6). In the majority of patients, MBs were located simultaneously in various parts of the brain, with a preference for cortical-subcortical regions (39%) and the basal ganglia/thalami (38%). There was some tendency toward a regional association between MB location and the site of the symptomatic hematoma, but we could not discern specific patterns of MB distribution. Logistic regression analysis identified MBs, periventricular hyperintensity grades, and lacunes but not risk factors as independent variables contributing to a correct classification of pICH and control individuals. Conclusions-MBs can be detected in more than half of the patients with pICH and appear to be quite general markers of various types of bleeding-prone microangiopathy. (Stroke. 2000;31:2665-2669.)

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“…6 Cerebral microhemorrhages, best visualized by MRI, result from rupture of small blood vessels in basal ganglia or subcortical white matter and are most often clinically asymptomatic. 2 Microhemorrhages were first described after the clinical use of GE MRI 2,3,7 and are usually defined as rounded foci of Ͻ5 mm in size that appear hypointense and distinct from vascular flow voids, leptomeningeal hemasiderosis, or nonhemorrhagic subcortical mineralization 2,8 (Figure). The reduction of the GE magnetic resonance (MR) signal is caused by hemosiderin, a blood breakdown product that causes magnetic susceptibility-induced relaxation leading to T2* signal loss.…”

Section: Definitionmentioning

confidence: 99%