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Abstract Details

Cerebral Microbleeds in Young Stroke Patients
Cerebrovascular Disease and Interventional Neurology
P04 - (-)
063
BACKGROUND: CMBs are believed to be a marker of vascular fragility and are encountered frequently in the setting of cerebrovascular disease. The prevalence of CMBs in young stroke patients has not been previously reported.
DESIGN/METHODS: Charts of consecutive patients 15-49 years of age admitted to Boston Medical Center with a diagnosis of ischemic stroke(IS) or spontaneous intraparenchymal hemorrhage (IPH) between 01/06 and 02/10 were reviewed (n=146). Patients with an interpretable T2*-gradient echo (GRE) sequence on MRI were eligible. Patients with vascular anomalies were excluded. We compared baseline demographics and vascular risk factors in patients with CMBs with those without CMBs. A similar analysis was performed to characterize the determinants of incident CMBs on subsequent neuroimaging.
RESULTS: CMBs were present in 16% of 100 eligible patients (17 IPH, 83 IS), with a mean age of 41. CMB number among individuals ranged from 1-125 (mean 15.3+/-32.8). Patients with CMBs were more likely to have IPH (44% vs. 12%,p<0.01), moderate-severe white matter hyperintensities (WMHs) on MRI (56% vs 27%,p=0.02), hypertension (73% vs 39%, p=0.01), and higher mean systolic (171 vs 150 mmHg, p=0.02) and diastolic (105 vs 87 mmHg, p=0.001) blood pressure on presentation. We observed nonsignificant trends towards increased mean age (43.8 vs. 40.7) and male gender (88% vs. 64%) in subjects with CMBs. In 31 patients with subsequent MRI, 13% had incident CMBs. Hypertension (100% vs. 40%, p<0.05) and higher initial mean CMB count (1.75 vs. 0.3, p<0.01) predicted the development of new CMBs.
CONCLUSIONS: Our preliminary data suggest that CMBs are prevalent in young stroke patients, with significant associations between the presence of CMBs and IPH, WMHs on MRI and hypertension. Further research is needed to better characterize CMBs in this stroke cohort.
Authors/Disclosures
Ashkan Shoamanesh, MD
PRESENTER 		Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .
Luciana Catanese, MD Dr. Catanese has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for IschemiaCare.
Melissa L. Rayhill, MD, FAAN (UBMD Neurology/University At Buffalo SUNY) Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with Headache Cooperative of New England. Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with Clusterbusters. Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with 好色先生.
Rony N. Salem, MD No disclosure on file
Helena W. Lau No disclosure on file
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center) The institution of Dr. Romero has received research support from NIH/NIA.
Viken L. Babikian, MD, FAAN Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Baim Institute for Clinical Research. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific.
Oscar R. Benavente, MD, FRCP(C) (Gordon and Leslie Diamond Health Care Centre) No disclosure on file
Carlos S. Kase, MD, FAHA, FAAN Dr. Kase has nothing to disclose.
Aleksandra Pikula, MD The institution of Dr. Pikula has received research support from CIHR.
Olga Ciccarelli, MD, PhD, FRCP (UCL Institute of Neurology) Prof. Ciccarelli has received personal compensation in the range of $0-$499 for serving as a Consultant for Lundebeck. Prof. Ciccarelli has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Prof. Ciccarelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Prof. Ciccarelli has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Prof. Ciccarelli has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEUROLOGY Journal.