Cerebral microbleeds: overview and implications in cognitive impairment

Abstract

Cerebral microbleeds (MBs) are small chronic brain hemorrhages which are likely caused by structural abnormalities of the small vessels of the brain. Owing to the paramagnetic properties of blood degradation products, MBs can be detected in vivo by using specific magnetic resonance imaging (MRI) sequences. Over the last decades, the implementation of these MRI sequences in both epidemiological and clinical studies has revealed MBs as a common finding in many different populations, including healthy individuals. Also, the topographic distribution of these MBs has been shown to be potentially associated with specific underlying vasculopathies. However, the clinical and prognostic significance of these small hemorrhages is still a matter of debate as well as a focus of extensive research. In this article, we aim to review the current knowledge on the pathophysiology and clinical implications of MBs, with special emphasis on the links between lobar MBs, cerebral amyloid angiopathy, and Alzheimer's disease.

Figure 1

Cerebral microbleeds as seen on magnetic resonance imaging gradient-recalled echo imaging (arrows). (A) Multiple lobar microbleeds distributed across the temporal lobes. (B) Isolated deep microbleed in the lateral aspect of the right thalamus.