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. 2008 Sep;79(9):1002-6.
doi: 10.1136/jnnp.2007.121913. Epub 2008 Feb 12.

Cerebral microbleeds in the population based AGES-Reykjavik study: prevalence and location

S Sveinbjornsdottir  1 , S Sigurdsson, T Aspelund, O Kjartansson, G Eiriksdottir, B Valtysdottir, O L Lopez, M A van Buchem, P V Jonsson, V Gudnason, L J Launer
Affiliations

Cerebral microbleeds in the population based AGES-Reykjavik study: prevalence and location

S Sveinbjornsdottir et al. J Neurol Neurosurg Psychiatry. 2008 Sep.

Abstract

Background and purpose: Incidental foci of signal loss suggestive of cerebral microbleeds (CMBs) are frequent findings on gradient echo T2* weighted MRI (T2* MRI) of patients with haemorrhagic or ischaemic stroke. There are few prevalence data on older populations. This paper reports on the prevalence and location of CMBs in a community based cohort of older men and women (born 1907-1935) who participated in the Age Gene/Environment Susceptibility (AGES)-Reykjavik Study, a population based cohort study that followed the Reykjavik Study

Methods: As part of the examination, all eligible and consenting cohort members underwent a full brain MRI, and blood was drawn for genotyping. Results are based on the first 1962 men (n = 820) and women (n = 1142), mean age 76 years, with complete MRI and demographic information available.

Results: Evidence of CMBs was found in 218 participants (11.1% (95% CI 9.8% to 12.6%)); men had significantly more CMBs than women (14.4% vs 8.8%; p = 0.0002, age adjusted). The prevalence of CMBs increased with age (p = 0.0001) in both men (p = 0.006) and women (p = 0.007). CMBs were located in the cerebral lobes (70%), the basal ganglia region (10.5%) and infratentorium (18.6%). Having a CMB was significantly associated with a homozygote Apo E epsilon4epsilon4 genotype (p = 0.01).

Conclusion: Cerebral microbleeds are common in older persons. The association with homozygote Apo E epsilon4 genotype and finding a relative predominance in the parietal lobes might indicate an association with amyloid angiopathy.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Cerebral microbleeds (CMBs), as seen on T2* weighted gradient echo type echo planar (GRE-EPI) MRI. To differentiate from areas of signal loss based on vascular flow voids, CMBs are scored if there is a focal area of signal loss on T2* weighted GRE-EPI images (A, arrows) that are invisible or smaller on T2 weighted fast spin echo images (B).
Figure 2
Figure 2
In the case of very high numbers of cerebral microbleeds (CMBs), it was difficult to distinguish between individual microbleeds and characterise them because of coalescing, so the recorded size and location of CMBs was limited to a maximum number of 30. The arrow points at what could be many adjacent CMBs that appear as one lesion due to coalescing.
Figure 3
Figure 3
Prevalence (with 95% confidence interval) of cerebral microbleeds by age and sex: the AGES-Reykjavik Study.
Figure 4
Figure 4
Distribution in the size of cerebral microbleeds (CMBs): the AGES-Reykjavik Study. There were 447 CMBs in 215 participants, median CMB size was 6 mm; if there were more than 30 CMBs (n = 3), size was not assessed.
See this image and copyright information in PMC

References

    1. Viswanathan A, Chabriat H. Cerebral microhemorrhage. Stroke 2006;37:550–5. - PubMed
    1. Cordonnier C, Al-Shahi Salman R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain 2007;130:1988–2003. - PubMed
    1. Fazekas F, Kleinert R, Roob G, 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. Am J Neuroradiol 1999;20:637–42. - PMC - PubMed
    1. Roob G, Lechner A, Schmidt AR, et al. Frequency and location of microbleeds in patients with primary intracerebral hemorrhage. Stroke 2000;31:2556–69. - PubMed
    1. Tanaka A, Ueno Y, Nakayama Y, et al. Small chronic hemorrhages and ischemic lesions in association with spontaneous intracerebral hematomas. Stroke 1999;30:1637–42. - PubMed

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