High rate of microbleed formation following primary intracerebral hemorrhage

Jason Mackey; Jeffrey J Wing; Gina Norato; Ian Sobotka; Ravi S Menon; Richard E Burgess; M Chris Gibbons; Nawar M Shara; Stephen Fernandez; Annapurni Jayam-Trouth; Laura Russell; Dorothy F Edwards; Chelsea S Kidwell

doi:10.1111/ijs.12607

High rate of microbleed formation following primary intracerebral hemorrhage

Int J Stroke. 2015 Dec;10(8):1187-91. doi: 10.1111/ijs.12607. Epub 2015 Aug 26.

Authors

Jason Mackey¹, Jeffrey J Wing², Gina Norato³, Ian Sobotka⁴, Ravi S Menon^{4

5}, Richard E Burgess^{4

6}, M Chris Gibbons⁷, Nawar M Shara⁸, Stephen Fernandez⁸, Annapurni Jayam-Trouth⁹, Laura Russell⁴, Dorothy F Edwards^{1

10}, Chelsea S Kidwell^{1

3

11}

Affiliations

¹ Department of Neurology, Indiana University, Indianapolis, IN, USA.
² Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
³ Department of Neurology, University of Arizona, Tucson, AZ, USA.
⁴ Department of Neurology, Georgetown University, Washington, DC, USA.
⁵ Swedish Neuroscience Institute, Seattle, WA, USA.
⁶ Central DuPage Hospital, Chicago, IL, USA.
⁷ Johns Hopkins Medical Institutions, Baltimore, MD, USA.
⁸ Medstar Research Institute, Hyattsville, MD, USA.
⁹ Department of Neurology, Howard University, Washington, DC, USA.
¹⁰ Department of Kinesiology, University of Wisconsin, Madison, WI, USA.
¹¹ Department of Medical Imaging, University of Arizona, Tucson, AZ, USA.

Abstract

Background: We sought to investigate the frequency of microbleed development following intracerebral hemorrhage in a predominantly African-American population and to identify predictors of new microbleed formation.

Aims and/or hypothesis: To investigate the frequency and predictors of new microbleeds following intracerebral hemorrhage.

Methods: The DECIPHER study was a prospective, longitudinal, magnetic resonance-based cohort study designed to evaluate racial/ethnic differences in risk factors for microbleeds and to evaluate the prognostic impact of microbleeds in this intracerebral hemorrhage population. We evaluated new microbleed formation in two time periods: from baseline to 30 days and from 30 days to year 1.

Results: Of 200 subjects enrolled in DECIPHER, 84 had magnetic resonance imaging at all required time points to meet criteria for this analysis. In the baseline to day 30 analysis, 11 (13·1%) had new microbleeds, compared with 25 (29·8%) in the day 30 to year 1 analysis. Logistic regression analysis demonstrated that baseline number of microbleeds [odds ratio 1·05 (95% confidence interval 1·01, 1·08), P = 0·01] was associated with new microbleed formation at 30 days. A logistic regression model predicting new microbleed at one-year included baseline number of microbleeds [odds ratio 1·05 (1·00, 1·11), P = 0·046], baseline age [odds ratio 1·05 (1·00, 1·10), P = 0·04], and white matter disease score [odds ratio 1·18 (0·96, 1·45). P = 0·115]. Overall, 28 of 84 (33·3%) intracerebral hemorrhage subjects formed new microbleeds at some point in the first year post-intracerebral hemorrhage.

Conclusions: We found that one-third of intracerebral hemorrhage subjects in this cohort surviving one-year developed new microbleeds, which suggests a dynamic and rapidly progressive vasculopathy. Future studies are needed to examine the impact of new microbleed formation on patient outcomes.

Keywords: MRI; brain bleed; brain microbleeds; cerebral hemorrhage; hemorrhage; intracerebral hemorrhage.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Brain / pathology
Female
Humans
Intracranial Hemorrhages / diagnosis
Intracranial Hemorrhages / ethnology
Intracranial Hemorrhages / etiology*
Intracranial Hemorrhages / pathology
Logistic Models
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Risk Factors
Stroke / complications*
Stroke / diagnosis
Stroke / ethnology
Stroke / pathology
Time Factors
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding