Cerebral microbleeds predict first-ever symptomatic cerebrovascular events.
OBJECTIVE
Cerebral microbleeds (CMB) on gradient-echo T2*-weighted magnetic resonance image (MRI) are frequently seen in patients with cerebral diseases. In this observational study we assessed whether CMB are a predictive factor for first-ever cerebrovascular events.


METHODS
This study consisted of 698 subjects without a history of symptomatic cerebrovascular events, who received gradient-echo T2*-weighted MRI for 3 months between November 2003 and January 2004 in Kishiwada City Hospital, Osaka, Japan. These subjects were then observed as outpatients for over 3.5 years.


RESULTS
The prevalence of CMB at baseline was 17.0% (119/698) in this population, and the follow-up rate was 51%. A total of 36 first-ever symptomatic cerebrovascular events were observed during the 3 and a half-year follow-up period. First-ever symptomatic cerebrovascular events occurred significantly more frequently in subjects with CMB (15 cases) than those without CMB (21 cases) (p=0.001). Even after adjusting for age, sex and hypertension, it was revealed that the presence of CMB was an independent predictor for the first-ever symptomatic cerebrovascular event by using the Cox proportional hazards model (hazard ratio, 2.87; 95% CI, 1.27-6.48; p=0.01).


CONCLUSIONS
The presence of CMB is an independent predictor of first-ever symptomatic cerebrovascular diseases.
Nishikawa
Tomofumi
T
Department of Neurosurgery, Kishiwada City Hospital, 1001 Gakuhara-cho, Kishiwada, Osaka 596-8501, Japan.
Ueba
Tetsuya
T
Kajiwara
Motohiro
M
Fujisawa
Ichro
I
Miyamatsu
Naomi
N
Yamashita
Kohsuke
K
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000473:pathology; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012984:Software; D020521:Stroke / Q000453:epidemiology