title: New cerebral microbleeds in ischemic stroke patients on warfarin treatment: two-year follow-up.
abstract: OBJECTIVE
  Cerebral microbleeds (CMBs) are known to be indicative of bleeding-prone microangiopathy. Little is known about the significance of CMBs in anticoagulated patients. We determined the frequency of new CMBs in ischemic stroke patients who had been receiving warfarin treatment for 2 years.
  
  
  METHODS
  A total of 204 ischemic stroke patients on warfarin therapy for 2 years underwent a repeat MRI. We compared demographic features, vascular risk factors, and radiological findings of patients with and without new CMBs.
  
  
  RESULTS
  New CMBs on gradient-echo MRI were found in 29 of 204 patients (10%). Of 35 patients who had CMBs in the original study, 9 developed new CMBs after 2 years (26%), compared with 20 of the 169 patients (12%) who did not have CMBs at baseline (p=0.03). Patients with new CMBs were older than patients without CMBs (p=0.04), and the frequency of leukoaraiosis was significantly higher (p=0.02). The mean duration of warfarin treatment was not significantly different between the patients with and without new CMBs (p=0.28).
  
  
  CONCLUSIONS
  This longitudinal study suggested that the presence of CMBs at baseline increased the frequency of new CMBs in patients on warfarin therapy.
authors.affiliation: Department of Neurology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey. dilek.necioglu@gmail.com
authors.forename: D Necioglu
authors.initials: DN
authors.lastname: Orken
authors.forename: E
authors.initials: E
authors.lastname: Uysal
authors.forename: E
authors.initials: E
authors.lastname: Timer
authors.forename: N
authors.initials: N
authors.lastname: Kuloglu-Pazarcı
authors.forename: S
authors.initials: S
authors.lastname: Mumcu
authors.forename: H
authors.initials: H
authors.lastname: Forta
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D019934:International Normalized Ratio; D049292:Leukoaraiosis / Q000150:complications; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000473:pathology; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Anticoagulant; Cerebral microbleed; Intracerebral hemorrhage; Warfarin