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Cho AH, Wadi L, Chow D, Chang P, Floriolli D, Shah K, Paganini-Hill A, Fisher M. Cerebral Microbleeds in a Stroke Prevention Clinic. Diagnostics (Basel) 2019; 10:diagnostics10010018. [PMID: 31905954 PMCID: PMC7168200 DOI: 10.3390/diagnostics10010018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 01/27/2023] Open
Abstract
The objective of this study was to assess the effectiveness of a stroke clinic in stroke prevention and progression of cerebral microbleeds (CMB). We conducted a retrospective observational study of patients who visited a stroke clinic between January 2011 and March 2017. Susceptibility-weighted imaging (SWI) MRI studies were obtained at baseline and follow-up visits to identify new infarctions and CMB progression. Patients with CMB who also underwent brain computed tomography (CT) imaging were identified and their cerebral arterial calcification was quantified to evaluate the relationship between the extent of intracranial calcification and CMB burden. A total of 64 stroke patients (mean age 73.1 ± 11.0, 47% males) had CMB on baseline and follow-up MRI studies. During a mean follow-up period of 22.6 months, four strokes occurred (4/64, 6%; 3 ischemic, 1 hemorrhagic), producing mild neurological deficit. Progression of CMB was observed in 54% of patients with two MRIs and was significantly associated with length of follow-up. Subjects with intracranial calcification score > 300 cm3 had higher CMB count than those with scores <300 cm3 at both baseline (12.6 ± 11.7 vs. 4.9 ± 2.2, p = 0.02) and follow-up (14.1 ± 11.8 vs. 5.6 ± 2.4, p = 0.03) MRI evaluations. Patients with CMB had a relatively benign overall clinical course. The association between CMB burden and intracranial calcification warrants further study.
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Affiliation(s)
- A-Hyun Cho
- Department of Neurology, University of California, Irvine, Orange, CA 92868, USA; (A.-H.C.); (L.W.); (K.S.); (A.P.-H.)
- Department of Neurology, Catholic University of Korea, College of Medicine, Seoul 06591, Korea
| | - Lara Wadi
- Department of Neurology, University of California, Irvine, Orange, CA 92868, USA; (A.-H.C.); (L.W.); (K.S.); (A.P.-H.)
| | - Daniel Chow
- Department of Radiological Sciences, University of California, Irvine, Orange, CA 92868, USA; (D.C.); (P.C.); (D.F.)
| | - Peter Chang
- Department of Radiological Sciences, University of California, Irvine, Orange, CA 92868, USA; (D.C.); (P.C.); (D.F.)
| | - David Floriolli
- Department of Radiological Sciences, University of California, Irvine, Orange, CA 92868, USA; (D.C.); (P.C.); (D.F.)
| | - Krunal Shah
- Department of Neurology, University of California, Irvine, Orange, CA 92868, USA; (A.-H.C.); (L.W.); (K.S.); (A.P.-H.)
| | - Annlia Paganini-Hill
- Department of Neurology, University of California, Irvine, Orange, CA 92868, USA; (A.-H.C.); (L.W.); (K.S.); (A.P.-H.)
| | - Mark Fisher
- Department of Neurology, University of California, Irvine, Orange, CA 92868, USA; (A.-H.C.); (L.W.); (K.S.); (A.P.-H.)
- Department of Pathology & Laboratory Medicine, University of California, Irvine, Orange, CA 92868, USA
- Correspondence: ; Tel.: +1-(714)-456-6856; Fax: +1-(714)-456-6573
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