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Cerebral microbleeds: a guide to detection and clinical relevance in different disease settings

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Abstract

Cerebral microbleeds have emerged as an important new imaging marker of cerebral small vessel disease. With the development of MRI techniques that are exquisitely sensitive to paramagnetic blood products, such as T2*-weighted gradient-recalled echo and susceptibility-weighted sequences, microbleeds have been detected in ever-increasing numbers of patients in stroke and cognitive clinics, as well as in healthy older people and in a variety of other rarer diseases and syndromes. Detection of cerebral microbleeds has clinical implications with respect to the diagnosis of the underlying small vessel disease, the safety of antithrombotic use, and the risk of symptomatic intracerebral haemorrhage, cognitive impairment and dementia. This article provides a guide to the detection and clinical relevance of cerebral microbleeds in different conditions based on a comprehensive review of the literature and own findings in research and clinical practice.

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Acknowledgments

AC receives research support from the Greek State Scholarship Foundation, Stroke Association and British Heart Foundation. DW is supported by a Department of Health and Higher Educational and Funding Council for England Clinical Senior Lectureship Award, the Stroke Association and British Heart Foundation. This work was undertaken at UCLH/UCL, who received a proportion of funding from the UK Department of Health’s National Institute for Health Research Biomedical Research Centres funding scheme. HRJ is supported by the National Institute for Health Research, University College London Hospitals Biomedical Research Centre, Stroke Association and British Heart Foundation.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Stroke Research Group, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK

    Andreas Charidimou & David J. Werring

  2. Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK

    Anant Krishnan & H. Rolf Jäger

  3. Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK

    H. Rolf Jäger

  4. UCL Institute of Neurology. The National Hospital for Neurology and Neurosurgery, University College Hospital (UCH), 8-11 Queen Square, Box 65, London, WC1 N3BG, UK

    H. Rolf Jäger

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  1. Andreas Charidimou
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  2. Anant Krishnan
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  3. David J. Werring
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  4. H. Rolf Jäger
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Correspondence to H. Rolf Jäger.

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Andreas Charidimou and Anant Krishnan contributed equally to this work.

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Charidimou, A., Krishnan, A., Werring, D.J. et al. Cerebral microbleeds: a guide to detection and clinical relevance in different disease settings. Neuroradiology 55, 655–674 (2013). https://doi.org/10.1007/s00234-013-1175-4

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