Asymptomatic cerebral bleeds in patients with aplastic anemia

Ann Hematol. 2012 Aug;91(8):1187-91. doi: 10.1007/s00277-012-1448-8. Epub 2012 Mar 24.

Abstract

Several studies suggest that cerebral microbleeds (CMB) seen on gradient echo magnetic resonance imaging (GE-MRI) of brain increase the future risk of intracranial hemorrhage (ICH). We investigated 26 newly diagnosed patients of aplastic anemia (AA) with GE-MRI of brain who were otherwise neurologically asymptomatic. These patients were then further followed up for a period of 6 months for development of overt ICH. The median age of patients was 20.5 years (range 12-40 years). The median values of complete blood counts at the time of diagnosis were hemoglobin 5.7 gm/dl (range 2.5-9.2 gm/dl), white cell count 2,320/μl (800-7,000/μl), and platelet count 11,500/μl (7000-45,000/μl). Three patients were detected to have CMB while two patients had asymptomatic cerebral macrobleeds (>1 cm). During the follow-up period of 6 months, two patients developed spontaneous ICH. None of the two patients had CMB at diagnosis. In conclusion, asymptomatic CMB were found in 11.5 % of patients with AA. The overall prevalence of asymptomatic ICH (CMB & macrobleeds) was 19.2 %. Further studies with larger number of patients are required to clearly delineate the association.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Aplastic / complications
  • Anemia, Aplastic / diagnostic imaging
  • Anemia, Aplastic / epidemiology*
  • Anemia, Aplastic / therapy
  • Asymptomatic Diseases / epidemiology*
  • Asymptomatic Diseases / therapy
  • Brain / diagnostic imaging
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / therapy
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Prevalence
  • Radiography
  • Risk Factors
  • Severity of Illness Index
  • Young Adult