Cerebral Microbleeds in the Patients With Acute Stroke Symptoms
Background: Some patients with acute stroke symptoms do not show hyperintensities on diffusion-weighted image (DWI). A few case reports have indicated that acutely developed cerebral microbleeds (CMBs) might cause focal symptoms. This study sought to investigate the incidence and characteristics of...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.00988/full |
| _version_ | 1819182916658266112 |
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| author | Sung Hyuk Heo Dongwhane Lee Yong Chul Kwon Bum Joon Kim Kyung Mi Lee Cheryl D. Bushnell Dae-IL Chang |
| author_facet | Sung Hyuk Heo Dongwhane Lee Yong Chul Kwon Bum Joon Kim Kyung Mi Lee Cheryl D. Bushnell Dae-IL Chang |
| author_sort | Sung Hyuk Heo |
| collection | DOAJ |
| description | Background: Some patients with acute stroke symptoms do not show hyperintensities on diffusion-weighted image (DWI). A few case reports have indicated that acutely developed cerebral microbleeds (CMBs) might cause focal symptoms. This study sought to investigate the incidence and characteristics of symptomatic CMBs in the patients with acute stroke symptoms but without DWI ischemic lesions.Methods: We enrolled the patients with acute stroke symptoms who underwent magnetic resonance imaging including DWI and gradient echo (GRE) sequences within 7 days after symptom onset, at our prospective stroke registry. We then identified patients without DWI-positive ischemic lesions but with CMBs in the relevant brain regions.Results: Between January 2005 and February 2012, we identified 235 DWI-negative transient ischemic attack (n = 221) and stroke (n = 14) patients from 2129 consecutive patients at our registry. In total, 16 patients had CMBs corresponding to the focal symptoms. Among these 16 patients, 12 patients showed a hyperintense rim on DWI around a microbleed suspected to be related to focal symptoms; of the 12 patients, 7 experienced stroke symptoms for more than 24 h. However, the symptoms in the remaining patients (5 patients with the hyperintense rim and 4 patients without the hyperintense rim) improved within 24 h.Conclusion: Symptomatic microbleeds are infrequent but not rare in the patients with acute stroke symptoms. Perihematomal edema around an acute CMB can cause a hyperintense rim on DWI. Our results suggest that a combination of DWI and GRE imaging can help diagnose acute symptomatic CMBs. |
| first_indexed | 2024-12-22T22:53:44Z |
| format | Article |
| id | doaj.art-8d0b765021a74767af77921441bf7e45 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-22T22:53:44Z |
| publishDate | 2018-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8d0b765021a74767af77921441bf7e452022-12-21T18:09:52ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-11-01910.3389/fneur.2018.00988412872Cerebral Microbleeds in the Patients With Acute Stroke SymptomsSung Hyuk Heo0Dongwhane Lee1Yong Chul Kwon2Bum Joon Kim3Kyung Mi Lee4Cheryl D. Bushnell5Dae-IL Chang6Department of Neurology, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Neurology, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Neurology, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Neurology, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Radiology, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United StatesDepartment of Neurology, Kyung Hee University Hospital, Seoul, South KoreaBackground: Some patients with acute stroke symptoms do not show hyperintensities on diffusion-weighted image (DWI). A few case reports have indicated that acutely developed cerebral microbleeds (CMBs) might cause focal symptoms. This study sought to investigate the incidence and characteristics of symptomatic CMBs in the patients with acute stroke symptoms but without DWI ischemic lesions.Methods: We enrolled the patients with acute stroke symptoms who underwent magnetic resonance imaging including DWI and gradient echo (GRE) sequences within 7 days after symptom onset, at our prospective stroke registry. We then identified patients without DWI-positive ischemic lesions but with CMBs in the relevant brain regions.Results: Between January 2005 and February 2012, we identified 235 DWI-negative transient ischemic attack (n = 221) and stroke (n = 14) patients from 2129 consecutive patients at our registry. In total, 16 patients had CMBs corresponding to the focal symptoms. Among these 16 patients, 12 patients showed a hyperintense rim on DWI around a microbleed suspected to be related to focal symptoms; of the 12 patients, 7 experienced stroke symptoms for more than 24 h. However, the symptoms in the remaining patients (5 patients with the hyperintense rim and 4 patients without the hyperintense rim) improved within 24 h.Conclusion: Symptomatic microbleeds are infrequent but not rare in the patients with acute stroke symptoms. Perihematomal edema around an acute CMB can cause a hyperintense rim on DWI. Our results suggest that a combination of DWI and GRE imaging can help diagnose acute symptomatic CMBs.https://www.frontiersin.org/article/10.3389/fneur.2018.00988/fullcerebral microbleedsdiffusion weighted imagestroketransient ischemic attackmagnetic resonance imagestroke |
| spellingShingle | Sung Hyuk Heo Dongwhane Lee Yong Chul Kwon Bum Joon Kim Kyung Mi Lee Cheryl D. Bushnell Dae-IL Chang Cerebral Microbleeds in the Patients With Acute Stroke Symptoms Frontiers in Neurology cerebral microbleeds diffusion weighted image stroke transient ischemic attack magnetic resonance image stroke |
| title | Cerebral Microbleeds in the Patients With Acute Stroke Symptoms |
| title_full | Cerebral Microbleeds in the Patients With Acute Stroke Symptoms |
| title_fullStr | Cerebral Microbleeds in the Patients With Acute Stroke Symptoms |
| title_full_unstemmed | Cerebral Microbleeds in the Patients With Acute Stroke Symptoms |
| title_short | Cerebral Microbleeds in the Patients With Acute Stroke Symptoms |
| title_sort | cerebral microbleeds in the patients with acute stroke symptoms |
| topic | cerebral microbleeds diffusion weighted image stroke transient ischemic attack magnetic resonance image stroke |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.00988/full |
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