Background: To define the cardiovascular risk factors for cerebral microbleeds and to investigate the relationship between microbleeds on the one hand, and the volume of age-related white matter hyperintensities (WMH) and atrophy on the other in an elderly population. Methods: Four hundred and thirty-nine elderly subjects (age range: 72–85; mean: 77) suffering from vascular disease or at high risk for developing this condition were included in this study. For each subject the number and localization of the microbleeds was recorded. Results: The prevalence of microbleeds in this study was 24%. We found age and a history of hypertension to be risk factors for microbleeds. After regional subdivision systolic blood pressure was found to be a risk factor for microbleeds located in the basal ganglia. A history of hypertension was more prevalent in patients with corticosubcortical and basal ganglia microbleeds. Magnetic resonance imaging risk factors associated with one or more microbleeds were total WMH volume, subcortical WMH volume, and periventricular WMH volume. Total WMH volume and periventricular WMH volume were risk factors for corticosubcortical microbleeds and basal ganglia microbleeds. Conclusion: A high prevalence of microbleeds was found in a population of patients suffering from vascular disease or at high risk for developing this condition. Age, hypertension and WMH were the most important risk factors for microbleeds, especially when located in the corticosubcortial junction or in the basal ganglia.

1.
Roob G, Schmidt R, Kapeller P, Lechner A, Hartung HP, Fazekas F: MRI evidence of past cerebral microbleeds in a healthy elderly population. Neurology 1999;52:991–994.
2.
Jeerakathil T, Wolf PA, Beiser A, Hald JK, Au R, Kase CS, et al: Cerebral microbleeds: prevalence and associations with cardiovascular risk factors in the Framingham Study. Stroke 2004;35:1831–1835.
3.
Koennecke HC: Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications. Neurology 2006;66:165–171.
4.
Ovbiagele B, Saver JL, Sanossian N, Salamon N, Villablanca P, Alger JR, et al: Predictors of cerebral microbleeds in acute ischemic stroke and TIA patients. Cerebrovasc Dis 2006;22:378–383.
5.
Cordonnier C, Al Shahi SR, Wardlaw J: Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain 2007;130:1988–2003.
6.
Greenberg SM, Eng JA, Ning M, Smith EE, Rosand J: Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage. Stroke 2004;35:1415–1420.
7.
Nighoghossian N, Hermier M, Adeleine P, Blanc-Lasserre K, Derex L, Honnorat J, Philippeau F, Dugor JF, Froment JC, Trouillas P: Old microbleeds are a potential risk factor for cerebral bleeding after ischemic stroke: a gradient-echo T2-weighted brain MRI study. Stroke 2002;33:735–742.
8.
Derex L, Nighoghossian N, Hermier M, Adeleine P, Philippeau F, Honnorat J, et al: Thrombolysis for ischemic stroke in patients with old microbleeds on pretreatment MRI. Cerebrovasc Dis 2004;17:238–241.
9.
Kohrmann M, Juttler E, Huttner HB, Nowe T, Schellinger PD: Acute stroke imaging for thrombolytic therapy – an update. Cerebrovasc Dis 2007;24:161–169.
10.
Fiehler J, Albers GW, Boulanger JM, Derex L, Gass A, Hjort N, et al: Bleeding Risk Analysis in Stroke Imaging before ThromboLysis (BRASIL): pooled analysis of T2-weighted magnetic resonance imaging data from 570 patients. Stroke 2007;38:2738–2744.
11.
Fazekas F, Kleinert R, Roob G, Kleinert G, Kapeller P, Schmidt R, et al: Histopathologic analysis of foci of signal loss on gradient-echo T2-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. AJNR Am J Neuroradiol 1999;20:637–642.
12.
Tanaka A, Ueno Y, Nakayama Y, Takano K, Takebayashi S: Small chronic hemorrhages and ischemic lesions in association with spontaneous intracerebral hematomas. Stroke 1999;30:1637–1642.
13.
Werring DJ, Frazer DW, Coward LJ, Losseff NA, Watt H, Cipolotti L, et al: Cognitive dysfunction in patients with cerebral microbleeds on T2-weighted gradient-echo MRI. Brain 2004;127:2265–2275.
14.
Shepherd J, Blauw GJ, Murphy MB, Cobbe SM, Bollen EL, Buckley BM, et al: The design of a prospective study of Pravastatin in the Elderly at Risk (PROSPER). PROSPER Study Group. PROspective Study of Pravastatin in the Elderly at Risk. Am J Cardiol 1999;84:1192–1197.
15.
Bakker CJ, Kouwenhoven M, Hartkamp MJ, Hoogeveen RM, Mali WP: Accuracy and precision of time-averaged flow as measured by nontriggered 2D phase-contrast MR angiography, a phantom evaluation. Magn Reson Imaging 1995;13:959–965.
16.
Admiraal-Behloul F, van den Heuvel DM, Olofsen H, van Osch MJ, van der Grond J, van Buchem MA, et al: Fully automatic segmentation of white matter hyperintensities in MR images of the elderly. Neuroimage 2005;28:607–617.
17.
van den Heuvel DM, Admiraal-Behloul F, ten Dam VH, Olofsen H, Bollen EL, Murray HM, et al: Different progression rates for deep white matter hyperintensities in elderly men and women. Neurology 2004;63:1699–1701.
18.
van der Flier WM, van den Heuvel DM, Weverling-Rijnsburger AW, Bollen EL, Westendorp RG, van Buchem MA, et al: Magnetization transfer imaging in normal aging, mild cognitive impairment, and Alzheimer’s disease. Ann Neurol 2002;52:62–67.
19.
van Es AC, van der Grond J, de Craen AJ, Admiraal-Behloul F, Blauw GJ, van Buchem MA: Caudate nucleus hypointensity in the elderly is associated with markers of neurodegeneration on MRI. Neurobiol Aging 2007, E-pub ahead of print. DOI: 10.1016/j.neurobiolaging.2007.05.008.
20.
van der Geest RJ, Niezen RA, van der Wall EE, de Roos A, Reiber JH: Automated measurement of volume flow in the ascending aorta using MR velocity maps: evaluation of inter- and intraobserver variability in healthy volunteers. J Comput Assist Tomogr 1998;22:904–911.
21.
Tsushima Y, Tanizaki Y, Aoki J, Endo K: MR detection of microhemorrhages in neurologically healthy adults. Neuroradiology 2002;44:31–36.
22.
Lee SH, Bae HJ, Ko SB, Kim H, Yoon BW, Roh JK: Comparative analysis of the spatial distribution and severity of cerebral microbleeds and old lacunes. J Neurol Neurosurg Psychiatry 2004;75:423–427.
23.
Chen YC, Wu YR, Hsu WC, Chen CM, Lee TH, Chen ST: Basal ganglia-thalamic hemorrhage in young adults: a hospital-based study. Cerebrovasc Dis 2006;22:33–39.
24.
Jackson CA, Sudlow CL: Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage? J Neurol Neurosurg Psychiatry 2006;77:1244–1252.
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