title: Asymptomatic cerebral bleeds in patients with aplastic anemia.
abstract: Several studies suggest that cerebral microbleeds (CMB) seen on gradient echo magnetic resonance imaging (GE-MRI) of brain increase the future risk of intracranial hemorrhage (ICH). We investigated 26 newly diagnosed patients of aplastic anemia (AA) with GE-MRI of brain who were otherwise neurologically asymptomatic. These patients were then further followed up for a period of 6 months for development of overt ICH. The median age of patients was 20.5 years (range 12-40 years). The median values of complete blood counts at the time of diagnosis were hemoglobin 5.7 gm/dl (range 2.5-9.2 gm/dl), white cell count 2,320/μl (800-7,000/μl), and platelet count 11,500/μl (7000-45,000/μl). Three patients were detected to have CMB while two patients had asymptomatic cerebral macrobleeds (>1 cm). During the follow-up period of 6 months, two patients developed spontaneous ICH. None of the two patients had CMB at diagnosis. In conclusion, asymptomatic CMB were found in 11.5 % of patients with AA. The overall prevalence of asymptomatic ICH (CMB & macrobleeds) was 19.2 %. Further studies with larger number of patients are required to clearly delineate the association.
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Sharma
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.forename: Vivek
authors.initials: V
authors.lastname: Lal
authors.forename: Paramjeet
authors.initials: P
authors.lastname: Singh
authors.forename: Neelam
authors.initials: N
authors.lastname: Varma
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D058070:Asymptomatic Diseases / Q000453:epidemiology* / Q000628:therapy; D001921:Brain / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult