The Association Between Hypertension and Cerebral Microbleeds in Patients With CADASIL.
- Author:
Jung Seok LEE
1
;
Sun Woo PARK
;
Sook Keun SONG
;
Jay Chol CHOI
;
Sa Yoon KANG
;
Ji Hoon KANG
Author Information
1. Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. nrlee71@naver.com
- Publication Type:Original Article
- Keywords:
Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL);
Cerebral microbleeds (CMBs);
Hypertension
- MeSH:
Asian Continental Ancestry Group;
Basal Ganglia;
Blood Pressure;
Brain;
CADASIL*;
Cerebral Hemorrhage;
Demography;
Humans;
Hypertension*;
Leukoencephalopathies;
Logistic Models;
Magnetic Resonance Imaging;
Risk Factors;
Thalamus
- From:Journal of the Korean Neurological Association
2014;32(2):82-87
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy that is caused by mutations in the Notch3 gene. Typical findings from magnetic resonance imaging (MRI) include multiple subcortical lacunae, extensive white-matter change, and multiple cerebral microbleeds (CMBs). CMBs are indicative of bleeding-prone microangiopathy. The rate of intracerebral hemorrhage in CADASIL is higher in Asian patients than in Caucasian patients. However, CMBs have not been thoroughly evaluated in Asian patients. We performed a detailed analysis of the frequency and distribution pattern of CMBs and assessed whether vascular risk factors exert an independent effect on CMBs in Asian CADASIL patients. METHODS: The study population comprised 60 patients who underwent brain MRI, including T2*-weighted gradient-echo sequences. Demographic factors, vascular risk factors, and MRI findings were compared between CADASIL patients with and without CMBs. The impact of vascular risk factors on CMBs, lacunae, and white-matter hyperintensities (WMHs) was assessed by logistic regression analysis. RESULTS: CMBs, which were detected in 34 (56.7%) patients, exhibited a significant predilection for the thalamus (46.7%), subcortical-cortical region (35.0%), and basal ganglia (31.7%). Hypertension, lacunae, and white-matter lesions were more common in patients with CMBs. Hypertension was an independent risk factor for CMBs, lacunae, and WMHs in patients with CADASIL. CONCLUSIONS: This study found that CMBs tended to occur in hypertensive patients with CADASIL. Further studies should focus on elucidating the association between reduced blood pressure and the number of CMBs.
