Background/Aims: The aim of the present study was to determine the association between arterial calcification and cerebral microbleeds (CMB) relative to their distribution. Methods: We identified 834 consecutive patients with acute ischemic stroke or transient ischemic attack who underwent CT angiography and susceptibility-weighted imaging. Results: Internal carotid artery (ICA) calcification and CMB were found in 660 patients (79.1%) and 335 patients (40.2%), respectively. ICA calcification was independently associated with CMB of any location (odds ratio, OR, 2.86, 95% CI 2.01-4.08, p < 0.0001). The association between calcification and deep CMB was stronger (OR 3.51, 95% CI 2.39-5.14, p < 0.0001). However, ICA calcification was not associated with CMB in a strictly lobar area. Conclusion: ICA calcification is an independent risk factor for deep CMB but not for a strictly lobar CMB. Our findings might contribute to the elucidation of the pathogenesis of cerebral small vessel disease.

1.
Pantoni L: Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 2010;9:689-701.
2.
Dierksen GA, Skehan ME, Khan MA, et al: Spatial relation between microbleeds and amyloid deposits in amyloid angiopathy. Ann Neurol 2010;68:545-548.
3.
Bokura H, Saika R, Yamaguchi T, et al: Microbleeds are associated with subsequent hemorrhagic and ischemic stroke in healthy elderly individuals. Stroke 2011;42:1867-1871.
4.
Vernooij MW, van der Lugt A, Ikram MA, et al: Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology 2008;70:1208-1214.
5.
Johnson RC, Leopold JA, Loscalzo J: Vascular calcification: pathobiological mechanisms and clinical implications. Circ Res 2006;99:1044-1059.
6.
Park KY, Kim YB, Moon HS, Suh BC, Chung PW: Association between cerebral arterial calcification and brachial-ankle pulse wave velocity in patients with acute ischemic stroke. Eur Neurol 2009;61:364-370.
7.
Chung PW, Park KY, Moon HS, et al: Intracranial internal carotid artery calcification: a representative for cerebral artery calcification and association with white matter hyperintensities. Cerebrovasc Dis 2010;30:65-71.
8.
Bos D, Ikram MA, Elias-Smale SE, et al: Calcification in major vessel beds relates to vascular brain disease. Arterioscler Thromb Vasc Biol 2011;31:2331-2337.
9.
Erbay S, Han R, Baccei S, et al: Intracranial carotid artery calcification on head CT and its association with ischemic changes on brain MRI in patients presenting with stroke-like symptoms: retrospective analysis. Neuroradiology 2007;49:27-33.
10.
Goos JD, van der Flier WM, Knol DL, et al: Clinical relevance of improved microbleed detection by susceptibility-weighted magnetic resonance imaging. Stroke 2011;42:1894-1900.
11.
Højsgaard S, Halekoh U, Yan J: The R package geepack for generalized estimating equations. J Stat Softw 2006;15:1-11.
12.
Poels MM, Vernooij MW, Ikram MA, et al: Prevalence and risk factors of cerebral microbleeds: an update of the Rotterdam Scan Study. Stroke 2010;41:S103-S106.
13.
Vidal JS, Sigurdsson S, Jonsdottir MK, et al: Coronary artery calcium, brain function and structure: the AGES-Reykjavik Study. Stroke 2010;41:891-897.
14.
O'Rourke MF, Safar ME: Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 2005;46:200-204.
15.
Liu W, Liu R, Sun W, et al: Different impacts of blood pressure variability on the progression of cerebral microbleeds and white matter lesions. Stroke 2012;43:2916-2922.
16.
Ramadan MM, Mahfouz EM, Gomaa GF, et al: Evaluation of coronary calcium score by multidetector computed tomography in relation to endothelial function and inflammatory markers in asymptomatic individuals. Circ J 2008;72:778-785.
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