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.
Brain microbleeds: Epidemiology and clinical implications
 
  Keywords
 
 
  
   Cerebral amyloid angiopathy
  
 
 
  
   Cognitive impairment
  
 
 
  
   Cerebrovascular disease
  
 
 
  
   Alzheimer disease
  
 
 
  
   Lipohyalinosis
  
 
 
  
   Brain microbleeds
  
 
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 <dis>cognitive impairment</dis>. 
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 <dis>cognitive impairment</dis>). 
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 <dis>cognitive impairment</dis>, 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.
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.
The pathological substrate of BMB is either lipohyalinosis (subcortical BMB) or cerebral amyloid angiopathy (lobar BMB). BMB exacerbate <dis>cognitive impairment</dis>, possibly through cortical-subcortical and intracortical disconnection, and increase the risk of death, mostly due to vascular causes.
cognitive impairment
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