Tuesday 27 September 2011

Cerebral Microbleeds

T2* GRE MRI sequence has high sensitivity in detecting cerebral microbleeds, which appear as small punctate (dot-like) hypointense lesions located widespread in bilateral cerebral cortical white matter , basal ganglia , thalami, cerebellum as well as brain stem and are histologically characterized by hemosiderin deposits with tissue damage.

Generally considered to be clinically silent.
Are strongly associated with intracerebral haemorrhage, hypertension, lacunar stroke and ischaemic small vessel disease, and have generated interest as a marker of bleeding-prone microangiopathy.
Also hypothesized that they would cause cognitive dysfunction.  (David J. Werring, Duncan W. Frazer, Lucy J. Coward, Nick A. Losseff,  Hilary Watt, Lisa Cipolotti, Martin M. Brown and H. Rolf Ja¨ger; Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI; Brain (2004), 127, 2265–2275)

April 22, 2009 — A new analysis from the Rotterdam Scan Study shows that cerebral microbleeds on MRI are more prevalent in elderly subjects who use platelet-aggregation inhibitors than in nonusers.
Their location in the brain is thought to reflect their underlying origin; microbleeds in infratentorial location are thought to relate to hypertensive or arteriosclerotic microangiopathy, while those in the strictly lobar brain sites result from cerebral amyloid angiopathy, a bleeding-prone state, the use of platelet aggregation inhibitors and anticoagulants in these patients has been found to be associated with increased occurrence of symptomatic hemorrhage.

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