Cerebral microbleeds (CMBs) are small cerebrovascular lesions. More and more CMBs have been found in patients with ischemic stroke, dementia, and cerebral amyloid angiopathy, as well as some normal elderly populations. The objective of this study is to summarize the main risk factor, impairment, and therapy of CMBs.
We searched and scanned all the literature with the keyword “cerebral microbleeds” or “CMBs” in the database of PubMed and Elsevier.
The risks factors for CMBs are complicated, including those that cause large-vessel disease, such as hypertension and old age, and those that cause small-vessel disease, such as amyloid deposits, endothelial lesions, and atrial fibrillation. Moreover, drugs and therapies used to treat cerebrovascular diseases such as statin, intravenous thrombolysis, and coumarin may also increase risk of CMBs. The relationship between antiplatelet treatment and CMBs is now unclear. Gene polymorphisms have been considered to be associated with CMBs. Gene mutations involving collagen type IV alpha 1 and collagen type IV alpha 2, sortilin-related receptor gene, forkhead box C1, and paired-like homeodomain 2 were reported to affect CMBs with the modification of corresponding proteins and functions. The cognition impairment caused by CMBs draws great attention. White matter deterioration is the possible answer. However, different studies could not reach the same conclusion on the damage of cognition of CMBs.
Further research is needed to provide effectual therapeutic proposals for CMBs, which differ from the treatment for large-artery disease and dementia.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Stroke and Cerebrovascular Diseases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Cerebral microbleeds and recurrent stroke risk: systematic review and meta-analysis of prospective ischemic stroke and transient ischemic attack cohorts.Stroke. 2013; 44: 995-1001
- Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions.Int J Stroke. 2015; 10: 469-478
- Management of cerebral small vessel disease for the diagnosis and treatment of dementia.Brain Nerve. 2013; 65: 801-809
- The number of microbleeds on gradient T2*-weighted magnetic resonance image at the onset of intracerebral hemorrhage.J Stroke Cerebrovasc Dis. 2008; 17: 30-34
- Cerebral microbleeds: a guide to detection and interpretation.Lancet Neurol. 2009; 8: 165-174
- Small-vessel disease in the basal ganglia: lacune or microbleed?.J Stroke Cerebrovasc Dis. 2012; 21 (e5-6): 905
- Cerebral microbleeds are associated with worse cognitive function: the Rotterdam Scan Study.Neurology. 2012; 78: 326-333
- Cerebral microbleeds and cognitive impairment in community-dwelling elderly from Singapore.Alzheimers Dement. 2012; 8: 618
- Relation of linear measures of atrophy, burden and topography of cerebral microbleeds and white matter hyperintensities with cognitive function in adults with otherwise normal MRI.Alzheimers Dement. 2011; 7: S222-S223
- Risk factors, stroke prevention treatments, and prevalence of cerebral microbleeds in the Framingham Heart Study.Stroke. 2014; 45: 1492-1494
- Different impacts of blood pressure variability on the progression of cerebral microbleeds and white matter lesions.Stroke. 2012; 43: 2916-2922
- Outcome markers for clinical trials in cerebral amyloid angiopathy.Lancet Neurol. 2014; 13: 419-428
- Lobar distribution of cerebral microbleeds: the Rotterdam Scan Study.Arch Neurol. 2011; 68: 656-659
- Microbleeds, amyloid-beta burden and FDG metabolism in non-demented elderly.Alzheimers Dement. 2011; 7: S698
- Distribution analysis of CMB in people with cognitive impairment and stroke.J Neurol Neurosurg Psychiatry. 2014; 85: 522-525
- Specific risk factors for microbleeds and white matter hyperintensities in Alzheimer's disease.Neurobiol Aging. 2013; 34: 2488-2494
- Microbleeds relate to altered amyloid-beta metabolism in Alzheimer's disease.Neurobiol Aging. 2012; 33 (e1-9): 1011
- Linking declining levels of plasma beta-amyloid 42 to Alzheimer's disease: the role of cerebral microbleeds.Alzheimers Dement. 2013; 9: 129
- Cerebral small vessel disease-induced apolipoprotein E leakage is associated with Alzheimer disease and the accumulation of amyloid beta-protein in perivascular astrocytes.J Neuropathol Exp Neurol. 2008; 67: 842-856
- Apolipoprotein E genotype influences spatial distribution of cerebral microbleeds.Neurobiol Aging. 2014; 35: 899-905
- Endothelial cells and human cerebral small vessel disease.Brain Pathol. 2015; 25: 44-50
- Analysis of cerebral lobar microbleeds and decreased cerebral blood flow in a memory clinic setting.Alzheimers Dement. 2014; 10 (Supplement:52)
- Angiogenic T-cells and putative endothelial progenitor cells in hypertension-related cerebral small vessel disease.Stroke. 2012; 43: 256-258
- Neuropathologic evidence of endothelial changes in cerebral small vessel disease.Neurology. 2012; 78: 167-174
- Vascular inflammation in cerebral small vessel disease.Neurobiol Aging. 2012; 33: 1800-1806
- Autoantibodies against oxidized low-density lipoprotein in cerebral small vessel disease.Stroke. 2010; 41: 2687-2689
- Dynamic temporal change of cerebral microbleeds: long-term follow-up MRI study.PLoS ONE. 2011; 6: e25930
- Cerebral microbleeds and asymptomatic cerebral infarctions in patients with atrial fibrillation.J Stroke Cerebrovasc Dis. 2014; 23: 1616-1622
- Number of cerebral microbleeds and risk of intracerebral hemorrhage after intravenous thrombolysis.Stroke. 2014; 45: 2900-2905
- Use of coumarin anticoagulants and cerebral microbleeds in the general population.Stroke. 2014; 5: 3436-3439
- Cerebral small-vessel disease associated with COL4A1 and COL4A2 gene duplications.Neurology. 2014; 83: 1029-1031
- COL4A1 mutations as a monogenic cause of cerebral small vessel disease: a systematic review.Stroke. 2010; 41: e513-e518
- Role of COL4A1 in basement-membrane integrity and cerebral small-vessel disease. The COL4A1 stroke syndrome.Curr Med Chem. 2010; 17: 1317-1324
- Genetic risk factors for cerebral small-vessel disease in hypertensive patients from a genetically isolated population.J Neurol Neurosurg Psychiatry. 2011; 82: 41-44
- Mutation of FOXC1 and PITX2 induces cerebral small-vessel disease.J Clin Invest. 2014; 124: 4877-4881
- High serum alkaline phosphatase in relation to cerebral small vessel disease.Atherosclerosis. 2014; 232: 313-318
- Visceral fat accumulation is associated with cerebral small vessel disease.Eur J Neurol. 2014; 21: 667-673
- Inflammatory biomarkers, cerebral microbleeds, and small vessel disease: Framingham Heart Study.Neurology. 2015; 84: 825-832
- Relations of blood inflammatory marker levels with cerebral microbleeds.Stroke. 2011; 42: 3202-3206
- Subjective cognitive failures in patients with hypertension are related to cognitive performance and cerebral microbleeds.Hypertension. 2014; 64: 653-657
- Microbleeds in vascular dementia: clinical aspects.Exp Gerontol. 2012; 47: 853-857
- Cerebral microbleeds are related to loss of white matter structural integrity.Neurology. 2013; 81: 1930-1937
- Cerebral small vessel disease affects white matter microstructure in mild cognitive impairment.Hum Brain Mapp. 2014; 35: 2836-2851
- Chapter 33 “Silent” cerebral infarcts and microbleeds.in: Handbook of clinical neurology. vol. 93. Elsevier, Amsterdam2008: 667-681
- Cerebral microbleeds are not associated with long-term cognitive outcome in patients with transient ischemic attack or minor stroke.Cerebrovasc Dis. 2014; 37: 195-202
- Prevalence and clinicoradiological analyses of patients with Alzheimer disease coexisting multiple microbleeds.J Stroke Cerebrovasc Dis. 2014; 23: 2444-2449
Published online: April 13, 2016
Accepted: March 4, 2016
Received in revised form: February 20, 2016
Received: December 1, 2015
All authors agree with the publication of this study.
© 2016 Published by Elsevier Inc. on behalf of National Stroke Association.