Cerebral microhemorrhages predict new disabling or fatal strokes in patients with acute ischemic stroke or transient ischemic attack.
OBJECTIVE
Cerebral microhemorrhages (MHs) are common among patients presenting with acute ischemic stroke and may predict both subsequent ischemic and hemorrhagic strokes.


METHODS
We prospectively studied patients with and without MHs presenting within 12 hours of their ischemic stroke or transient ischemic attack (TIA). A magnetic resonance (MR) scan was performed within 24 hours of symptom(s) onset. The primary outcome was disabling or fatal stroke at 18 months.


RESULTS
An MR scan was done in 236 patients with acute ischemic stroke or TIA. Forty-five (19.1%) patients had an MH on a baseline MR scan. Patients with MHs were 2.8x (10.8% versus 4.0%; P=0.036) more likely to have a subsequent disabling or fatal stroke than patients without an MH. The risk of symptomatic intracerebral hemorrhage was not statistically significant among MH and non-MH patients (3.3% versus 0.8%; P=0.31).


CONCLUSIONS
The presence of cerebral MH(s) in patients with acute ischemic stroke or TIA predicts recurrent disabling and fatal strokes. This risk is mainly assumed by recurrent ischemic strokes.
Clinique Neuro Rive-Sud, 4896 Blvd Taschereau 250, Greenfield Park, Provinvr of Quebec, Canada, J4V 2J2. jbouboul@hotmail.com.
Jean-Martin
JM
Boulanger
Shelagh B
SB
Coutts
Michael
M
Eliasziw
A J
AJ
Gagnon
Jessica E
JE
Simon
Suresh
S
Subramaniam
Chul-Ho
CH
Sohn
James
J
Scott
Andrew M
AM
Demchuk
D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000378:metabolism / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D002546:Ischemic Attack, Transient / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D015233:Models, Statistical; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome