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Abstract:

Introduction Brain microbleeds ( BMB ) are haemosiderin deposits contained within macrophages , which are displayed as hypointense images in some T2 - weighted magnetic resonance imaging sequences . There are still many questions to be answered about the pathophysiology and clinical relevance of BMB . Development We conducted a literature review of the main epidemiological , clinical , and anatomical pathology studies of BMB performed in the general population , in patients at risk of or already suffering from a vascular disease , and in patients with cognitive impairment . We analysed the prevalence of BMB , risk factors , and potential pathophysiological mechanisms and clinical implications . Conclusions The prevalence of BMB is highly variable ( 3% - 27% in the general population , 6% - 80% in patients with vascular risk factors or vascular disease , and 16% - 45% in patients with cognitive impairment ) . BMB are associated with ageing , Alzheimer disease ( AD ) , and in particular haemorrhagic or ischaemic cerebrovascular disease . The pathological substrate of BMB is either lipohyalinosis ( subcortical BMB ) or cerebral amyloid angiopathy ( lobar BMB ) . BMB exacerbate cognitive impairment , possibly through cortical - subcortical and intracortical disconnection , and increase the risk of death , mostly due to vascular causes . BMB also increase the risk of cerebral haemorrhage , particularly in patients with multiple lobar BMB ( probable erebral amyloid angiopathy ) . Therefore , anticoagulant treatment may be contraindicated in these patients . In patients with lower risk of bleeding , the new oral anticoagulants and the combination of clinical and magnetic resonance imaging follow - up could be helpful in the decision - making process .
cognitive impairment
cognitive impairment
cognitive impairment