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Cerebral Microbleeds Prevalent in Older Adults

Risk factors vary for strictly lobar microbleeds and deep or infratentorial microbleeds

TUESDAY, April 1 (HealthDay News) -- In older adults, the prevalence of cerebral microbleeds may be significantly higher than commonly believed and risk factors vary according to microbleed location, according to study findings published in the April 1 issue of Neurology.

Meike W. Vernooij, M.D., of the Erasmus MC University Medical Center in Rotterdam, the Netherlands, and colleagues used an MRI sequence that was optimized for the detection of cerebral microbleeds to study 1,062 randomly selected older adults (mean age 69.6 years). They also studied the relationship between the APOE genotype, cardiovascular risk factors and markers of small vessel disease, and the presence and location of microbleeds.

The investigators found that the overall prevalence of cerebral microbleeds was three to four times higher than previous estimates, ranging from 17.8 percent in subjects aged 60 to 69 to 38.3 percent in subjects over age 80. They found that APOEe4 carriers were significantly more likely than non-carriers to have strictly lobar microbleeds. According to the researchers, the data support the hypothesis that strictly lobar microbleeds are related to cerebral amyloid angiopathy, while deep or infratentorial microbleeds result from hypertensive or atherosclerotic microangiopathy.

"The high prevalence of cerebral microbleeds in our study as well as the finding that risk factors vary according to microbleed location has major importance in view of previous reports from small clinical series suggesting that microbleeds may reflect an increased risk of recurrence of stroke and hemorrhagic transformation of ischemic stroke," the authors write.

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