title: Microbleeds are associated with subsequent hemorrhagic and ischemic stroke in healthy elderly individuals.
abstract: OBJECTIVE
  Cerebral microbleeds (MBs) are frequently detected in patients with stroke, especially those who experience intracerebral hemorrhage. However, the clinical significance of MBs in subjects without cerebrovascular disease is still unclear. We performed a prospective study to determine whether the presence of MBs provides useful prognostic information in healthy elderly individuals.
  
  
  METHODS
  We tracked 2102 subjects (mean age, 62.1 years) over a mean interval of 3.6 years after they voluntarily participated in the brain checkup system at the Shimane Institute of Health Science. An initial assessment was performed to document the presence of MBs and silent ischemic brain lesions and to map the location of the MBs. During the follow-up period, we obtained information about stroke events that occurred in each subject.
  
  
  RESULTS
  MBs were detected in 93 of the 2102 subjects (4.4%). Strokes occurred in 44 subjects (2.1%) during the follow-up period. They were significantly more common among subjects with MBs. Age and hypertension were independent risk factors for MBs. The presence of MBs was more strongly associated with a deep brain hemorrhage (hazard ratio, 50.2; 95% CI, 16.7 to 150.9) than ischemic stroke (hazard ratio, 4.48; 95% CI, 2.20 to 12.2). All hemorrhagic strokes occurred in deep brain regions, and they were associated with MBs located in the deep brain region.
  
  
  CONCLUSIONS
  This longitudinal study demonstrated that the presence of MBs can be used to predict hemorrhagic and ischemic stroke, even in healthy elderly individuals.
authors: Department of Neurology, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Japan.
authors: Hirokazu
authors: H
authors: Bokura
authors: Reiko
authors: R
authors: Saika
authors: Takuya
authors: T
authors: Yamaguchi
authors: Atsushi
authors: A
authors: Nagai
authors: Hiroaki
authors: H
authors: Oguro
authors: Shotai
authors: S
authors: Kobayashi
authors: Shuhei
authors: S
authors: Yamaguchi