#WeekendLecture
#CerebralMicrobleeds #CMB
Radiological construct: small (2–10 mm diameter) round or ovoid #hypointense foci with associated #blooming with enhanced visibility on #MRI sequences sensitive to #susceptibility effects
thelancet.com/journals/laneu…
#CerebralMicrobleeds #CMB
Radiological construct: small (2–10 mm diameter) round or ovoid #hypointense foci with associated #blooming with enhanced visibility on #MRI sequences sensitive to #susceptibility effects
thelancet.com/journals/laneu…
#WeekendLecture
#CMB
🔬#Pathology: recent or old microhaemorrhages
🩸Microvessel injuries, ie: dilatation/fragmentation of the wall, amyloid-ß (in CAA) and fibrin extravasation
🩸Extravasation of red blood cells
🩸#hemosiderin-laden macrophages
karger.com/Article/FullTe…
#CMB
🔬#Pathology: recent or old microhaemorrhages
🩸Microvessel injuries, ie: dilatation/fragmentation of the wall, amyloid-ß (in CAA) and fibrin extravasation
🩸Extravasation of red blood cells
🩸#hemosiderin-laden macrophages
karger.com/Article/FullTe…
#WeekendLecture
In daily practice #CMB represents a radiological marker of #small vessel disease
In general:
🩸Strictly #lobar CMBs👉CAA
🩸Strictly #deep👉hypertension-related SVD ie #arteriolosclerosis
🩸Mixed 👉combination👆, but must think #hereditary #SVD, ie #CADASIL
In daily practice #CMB represents a radiological marker of #small vessel disease
In general:
🩸Strictly #lobar CMBs👉CAA
🩸Strictly #deep👉hypertension-related SVD ie #arteriolosclerosis
🩸Mixed 👉combination👆, but must think #hereditary #SVD, ie #CADASIL
#WeekendLecture
#CMB #prevalence vary according to age & neuroimaging: 5-35%
🧠#Incidence: 7-10% from #Rotterdam Scan study
🧠Patients with stroke have #higher prevalence:
🩸34% in IS
🩸60% in sICH
academic.oup.com/brain/article/…
#CMB #prevalence vary according to age & neuroimaging: 5-35%
🧠#Incidence: 7-10% from #Rotterdam Scan study
🧠Patients with stroke have #higher prevalence:
🩸34% in IS
🩸60% in sICH
academic.oup.com/brain/article/…
#WeekendLecture
#CMB
Markers of CV risk:
🩸If no #stroke history:⬆️5.5x risk of ICH & 2x risk of IS
🩸In sICH pts⬆️4.4x recurrence risk
🩸In IS/TIA pts⬆️3x risk of ICH & 20% risk of new IS; absolute risk of IS is higher than ICH
👉strokejournal.org/article/S1052-…
👉n.neurology.org/content/89/8/8…
#CMB
Markers of CV risk:
🩸If no #stroke history:⬆️5.5x risk of ICH & 2x risk of IS
🩸In sICH pts⬆️4.4x recurrence risk
🩸In IS/TIA pts⬆️3x risk of ICH & 20% risk of new IS; absolute risk of IS is higher than ICH
👉strokejournal.org/article/S1052-…
👉n.neurology.org/content/89/8/8…
#WeekendLecture
#CMB can serve as prognostic markers for⬆️sICH risk in pts with CVD
☝️But their presence does not seem to modify the effect of #antithrombotic therapy on clinical #outcomes, including #anticoagulation
ahajournals.org/doi/10.1161/ST…
#NAVIGATE:jamanetwork.com/journals/jaman…
#CMB can serve as prognostic markers for⬆️sICH risk in pts with CVD
☝️But their presence does not seem to modify the effect of #antithrombotic therapy on clinical #outcomes, including #anticoagulation
ahajournals.org/doi/10.1161/ST…
#NAVIGATE:jamanetwork.com/journals/jaman…
#WeekendLecture
#CMB & acute IS therapy
🧠>10 #CMB could⏬IVT treatment effect, but should not be used as an isolated factor
☝️No need to perform MRI looking for #CMB before IVT
☝️#LVO? There is no data to exclude pts from #EVT treatment based on #CMB
ahajournals.org/doi/10.1161/ST…
#CMB & acute IS therapy
🧠>10 #CMB could⏬IVT treatment effect, but should not be used as an isolated factor
☝️No need to perform MRI looking for #CMB before IVT
☝️#LVO? There is no data to exclude pts from #EVT treatment based on #CMB
ahajournals.org/doi/10.1161/ST…
This #WeekendLecture is based on the terrific review
"Cerebral #microbleeds: from depiction to interpretation"
from @Lau_Puy @marco_pasi85 @SusanneVanVeluw @PrCCordonnier et al
A #mustread for everyone working with #stroke patients
#neurotwitter
🆓
jnnp.bmj.com/content/92/6/5…
"Cerebral #microbleeds: from depiction to interpretation"
from @Lau_Puy @marco_pasi85 @SusanneVanVeluw @PrCCordonnier et al
A #mustread for everyone working with #stroke patients
#neurotwitter
🆓
jnnp.bmj.com/content/92/6/5…
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