title: Stroke patients with cerebral microbleeds on MRI scans have arteriolosclerosis as well as systemic atherosclerosis.
abstract: Cerebral microbleeds (CMBs) are recognized as a manifestation of arteriolosclerosis in cerebral small vessels. However, little is known regarding whether stroke patients with CMBs often have systemic atherosclerosis. The aim of the present study was to elucidate this issue using the cardio-ankle vascular index (CAVI), a new index of systemic atherosclerosis, in acute ischemic stroke patients. We prospectively studied 105 patients (71 males, median age=70.0 years) with acute ischemic stroke. All of the patients were examined using T2*-weighted gradient echo magnetic resonance imaging (MRI) to look for and assess the CMBs and using fluid-attenuated inversion recovery to evaluate white matter hyperintensity (WMH). We assigned the patients into CMB and non-CMB groups and compared the clinical characteristics of these groups. The factors associated with CMBs were investigated using multivariate logistic regression analysis. T2*-weighted gradient echo MRI revealed CMBs in 47 patients (44.8%) and no CMBs in 58 patients (55.2%). The CAVI was significantly higher in the CMBs group (10.5 vs. 8.6, P<0.001). In the multivariate logistic regression analysis, CAVI per one point increase (odds ratio (OR), 1.50; 95% confidence interval (CI), 1.12-2.00; P=0.006), advanced WMH (OR, 4.78; 95% CI, 1.55-14.74; P=0.006) and impaired kidney function (OR, 3.31; 95% CI, 1.16-9.81; P=0.031) were independent factors associated with the presence of CMBs. A high CAVI was independently associated with CMBs in patients with acute ischemic stroke. Our results indicated that ischemic stroke patients with CMBs may have cerebral arteriolosclerosis as well as systemic atherosclerosis.
authors: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors: Takashi
authors: T
authors: Shimoyama
authors: Yasuyuki
authors: Y
authors: Iguchi
authors: Kazumi
authors: K
authors: Kimura
authors: Hidetaka
authors: H
authors: Mitsumura
authors: Renpei
authors: R
authors: Sengoku
authors: Yu
authors: Y
authors: Kono
authors: Masayo
authors: M
authors: Morita
authors: Soichiro
authors: S
authors: Mochio
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000175:diagnosis; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow; D020521:Stroke / Q000209:etiology*