Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy
BackgroundCerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common genetic cause of stroke. In addition to ischemic stroke, CADASIL predisposes to development of cerebral microbleeds (CMB). CMB and hypertension are known to be associated...
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Frontiers Media S.A.
2017-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00203/full |
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| author | Jung Seok Lee Jung Seok Lee KeunHyuk Ko Jung-Hwan Oh Joon Hyuk Park Ho Kyu Lee David Floriolli Annlia Paganini-Hill Mark Fisher Mark Fisher Mark Fisher |
| author_facet | Jung Seok Lee Jung Seok Lee KeunHyuk Ko Jung-Hwan Oh Joon Hyuk Park Ho Kyu Lee David Floriolli Annlia Paganini-Hill Mark Fisher Mark Fisher Mark Fisher |
| author_sort | Jung Seok Lee |
| collection | DOAJ |
| description | BackgroundCerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common genetic cause of stroke. In addition to ischemic stroke, CADASIL predisposes to development of cerebral microbleeds (CMB). CMB and hypertension are known to be associated with intracerebral hemorrhage (ICH). The purpose of this study was to analyze the relationships among CMB, hypertension, and ICH in CADASIL.Materials and methodsWe enrolled 94 genetically confirmed CADASIL patients from 76 unrelated families at Jeju National University Hospital (Korea) between March 2012 and February 2015. We analyzed CMB presence, number, and distribution on susceptibility-weighted imaging MRI using the microbleed anatomical rating scale. Multiple logistic regression was used to determine factors associated with the presence of CMB and ICH.ResultsCMB were observed in 62 patients (66%), median number of CMB per patient was 4 (range 0–121). Twenty-two ICHs were found in 16 patients (17%). There was incongruence between the most common site of CMB (thalamus) and that of ICH (basal ganglia). Hypertension was independently associated with the presence of CMB (multiple regression OR, 2.71; 95% CI 1.02–7.18, p < 0.05), and CMB ≥ 9 (highest third) was significantly associated with the presence of ICH (multiple regression OR = 9.50, 95% CI 1.08–83.71, p < 0.05).ConclusionIn this CADASIL sample, presence of hypertension was independently associated with CMB presence, and CMB burden was independently associated with ICH. Incongruence of sites for CMB and ICH is currently unexplained and requires further study. |
| first_indexed | 2024-12-11T17:46:36Z |
| format | Article |
| id | doaj.art-9b02a226407540d2bd04eeb69dba7c96 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T17:46:36Z |
| publishDate | 2017-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-9b02a226407540d2bd04eeb69dba7c962022-12-22T00:56:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-05-01810.3389/fneur.2017.00203251357Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and LeukoencephalopathyJung Seok Lee0Jung Seok Lee1KeunHyuk Ko2Jung-Hwan Oh3Joon Hyuk Park4Ho Kyu Lee5David Floriolli6Annlia Paganini-Hill7Mark Fisher8Mark Fisher9Mark Fisher10Department of Neurology, Jeju National University School of Medicine, Jeju City, South KoreaDepartment of Neurology, University of California Irvine School of Medicine, Irvine, CA, United StatesDepartment of Neurology, Jeju National University School of Medicine, Jeju City, South KoreaDepartment of Neurology, Jeju National University School of Medicine, Jeju City, South KoreaDepartment of Psychiatry, Jeju National University School of Medicine, Jeju City, South KoreaDepartment of Radiology, Jeju National University School of Medicine, Jeju City, South KoreaDepartment of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA, United StatesDepartment of Neurology, University of California Irvine School of Medicine, Irvine, CA, United StatesDepartment of Neurology, University of California Irvine School of Medicine, Irvine, CA, United StatesDepartment of Anatomy & Neurobiology, University of California Irvine School of Medicine, Irvine, CA, United StatesDepartment of Pathology & Laboratory Medicine, University of California Irvine School of Medicine, Irvine, CA, United StatesBackgroundCerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common genetic cause of stroke. In addition to ischemic stroke, CADASIL predisposes to development of cerebral microbleeds (CMB). CMB and hypertension are known to be associated with intracerebral hemorrhage (ICH). The purpose of this study was to analyze the relationships among CMB, hypertension, and ICH in CADASIL.Materials and methodsWe enrolled 94 genetically confirmed CADASIL patients from 76 unrelated families at Jeju National University Hospital (Korea) between March 2012 and February 2015. We analyzed CMB presence, number, and distribution on susceptibility-weighted imaging MRI using the microbleed anatomical rating scale. Multiple logistic regression was used to determine factors associated with the presence of CMB and ICH.ResultsCMB were observed in 62 patients (66%), median number of CMB per patient was 4 (range 0–121). Twenty-two ICHs were found in 16 patients (17%). There was incongruence between the most common site of CMB (thalamus) and that of ICH (basal ganglia). Hypertension was independently associated with the presence of CMB (multiple regression OR, 2.71; 95% CI 1.02–7.18, p < 0.05), and CMB ≥ 9 (highest third) was significantly associated with the presence of ICH (multiple regression OR = 9.50, 95% CI 1.08–83.71, p < 0.05).ConclusionIn this CADASIL sample, presence of hypertension was independently associated with CMB presence, and CMB burden was independently associated with ICH. Incongruence of sites for CMB and ICH is currently unexplained and requires further study.http://journal.frontiersin.org/article/10.3389/fneur.2017.00203/fullCADASILmicrobleedshypertensionintracerebral hemorrhagestroke |
| spellingShingle | Jung Seok Lee Jung Seok Lee KeunHyuk Ko Jung-Hwan Oh Joon Hyuk Park Ho Kyu Lee David Floriolli Annlia Paganini-Hill Mark Fisher Mark Fisher Mark Fisher Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy Frontiers in Neurology CADASIL microbleeds hypertension intracerebral hemorrhage stroke |
| title | Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy |
| title_full | Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy |
| title_fullStr | Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy |
| title_full_unstemmed | Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy |
| title_short | Cerebral Microbleeds, Hypertension, and Intracerebral Hemorrhage in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy |
| title_sort | cerebral microbleeds hypertension and intracerebral hemorrhage in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy |
| topic | CADASIL microbleeds hypertension intracerebral hemorrhage stroke |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00203/full |
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