Clinical significance of cerebral microbleeds in patients with germinoma who underwent long-term follow-up

J Neurooncol. 2024 Oct;170(1):173-184. doi: 10.1007/s11060-024-04753-9. Epub 2024 Aug 12.

Abstract

Purpose: This study identified the factors affecting cerebral microbleed (CMBs) development. Moreover, their effects on intelligence and memory and association with stroke in patients with germinoma who had long-term follow-up were evaluated.

Methods: This study included 64 patients with germinoma who were histologically and clinically diagnosed with and treated for germinoma. These patients were evaluated cross-sectionally, with a focus on CMBs on susceptibility-weighted magnetic resonance imaging (SWI), brain atrophy assessed through volumetric analysis, and intelligence and memory.

Results: The follow-up period was from 32 to 412 (median: 175.5) months. In total, 43 (67%) patients had 509 CMBs and 21 did not have CMBs. Moderate correlations were observed between the number of CMBs and time from initial treatments and recurrence was found to be a risk factor for CMB development. Increased temporal CMBs had a marginal effect on the processing speed and visual memory, whereas brain atrophy had a statistically significant effect on verbal, visual, and general memory and a marginal effect on processing speed. Before SWI acquisition and during the follow-up periods, eight strokes occurred in four patients. All of these patients had ≥ 15 CMBs on SWI before stroke onset. Meanwhile, 33 patients with < 14 CMBs or 21 patients without CMBs did not experience stroke.

Conclusion: Patients with a longer time from treatment initiation had a higher number of CMBs, and recurrence was a significant risk factor for CMB development. Furthermore, brain atrophy had a stronger effect on memory than CMBs. Increased CMBs predict the stroke onset.

Keywords: Brain atrophy; Cerebral microbleeds; Germinoma; Intelligence; Memory; Stroke.

MeSH terms

  • Adolescent
  • Adult
  • Atrophy / pathology
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Neoplasms / complications
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology
  • Cerebral Hemorrhage* / diagnostic imaging
  • Cerebral Hemorrhage* / etiology
  • Cerebral Hemorrhage* / pathology
  • Child
  • Clinical Relevance
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Germinoma* / complications
  • Germinoma* / diagnostic imaging
  • Germinoma* / pathology
  • Humans
  • Intelligence
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Risk Factors
  • Young Adult

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