title: Dot-like hemosiderin spots on gradient echo T2*-weighted magnetic resonance imaging are associated with past history of small vessel disease in patients with intracerebral hemorrhage.
abstract: OBJECTIVE
  Lipohyalinosis is considered an important cause of cerebral small vessel disease (SVD), including hypertensive intracerebral hematoma (ICH) and lacunar infarction. Dot-like low-intensity spots (dot-like hemosiderin spots [dotHSs]) on gradient-echo T2*-weighted (T2*-w) magnetic resonance imaging (MRI) have been histologically diagnosed as old microbleeds associated with microangiopathies (lipohyalinosis, amyloid angiopathy) and located in territories of perforating arteries (deep dotHSs) and subcortical regions (subcortical dotHSs). If dotHSs indicate the severity of lipohyalinosis, larger numbers of deep dotHSs may be associated with past history of SVD.
  
  
  METHODS
  The number of dotHSs was investigated in 213 patients with deep ICH (106 men, 107 women, 37 to 94 years old, mean age = 65.8 +/- 11.2 years). Patients were divided into 2 subgroups according to past history of SVD. Odds ratio (OR) for the history was estimated from logistic regression analyses of the number of deep or subcortical dotHSs, as well as other factors.
  
  
  RESULTS
  Of 213 patients, 36 had a past history of SVD (symptomatic deep ICH in 18, symptomatic lacunar infarction in 17, and both in 1). An increased rate of history of SVD was found for patients with subcortical dotHSs. The OR per 1 subcortical dotHS was 1.09 (95% confidence internal (CI), 1.03-1.17; P =.005), and per deep dotHS, the OR was 1.07 (95% CI, 1.00-1.13; P =.039).
  
  
  CONCLUSIONS
  The findings suggest that deep and subcortical dotHSs on T2*-w MRI may indicate the severity of microangiopathy and may predict recurrence of SVD in patients with deep ICH.
authors.affiliation: Department of Neurosurgery, Hakodate Municipal Hospital, Hokkaido, Japan. kh8018@kushiro-cghp.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Horita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Chiba
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Toshimi
authors.initials: T
authors.lastname: Honma
authors.forename: Jun
authors.initials: J
authors.lastname: Niwa
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000473:pathology*; D005260:Female; D006485:Hemosiderin / Q000032:analysis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male
chemical_list: D006485:Hemosiderin