Different distribution patterns of cerebral microbleeds in acute ischemic stroke patients with and without hypertension

Eur Neurol. 2009;62(5):298-303. doi: 10.1159/000235850. Epub 2009 Aug 29.

Abstract

Background: Cerebral microbleeds (CMBs) were found in patients with and without hypertension. We aimed to investigate different distribution patterns of CMBs in patients with and without hypertension.

Methods: We examined acute ischemic stroke patients using a standardized MRI protocol that included T(1), T(2) and gradient-echo T(2)*. Clinical and imaging characteristics were collected from all patients.

Results: Among 998 patients, CMBs were detected in 273 patients (27.3%). Of these, 62 did not have hypertension (22.7%). The incidence of CMBs among patients without hypertension (62/335, 18.5%) was lower than among those with hypertension (211/663, 31.8%; p < 0.01). The location of CMBs in patients without hypertension was limited to the cortical-subcortical (CSC) region in 40.3% (25/62) compared to 20.4% of those with hypertension (43/211; p = 0.01). No significant difference was found between CMB locations within the intra-CSC region in both groups. The severity of white matter changes and systolic blood pressure on admission were found to be independent predictors for CMBs in patients without hypertension.

Conclusions: CMBs in patients with and without hypertension have different distribution patterns and may have a different pathogenesis. Blood pressure controlling is important in both groups because systolic blood pressure is an independent predictor of CMBs in patients without hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Mapping
  • Cerebral Cortex / blood supply
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology*
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / pathology
  • Cerebral Hemorrhage / physiopathology*
  • Cerebral Infarction / complications*
  • Cerebral Infarction / pathology
  • Cerebral Infarction / physiopathology*
  • Cerebrovascular Circulation
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / physiopathology*
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Microcirculation
  • Patient Selection
  • Regression Analysis