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Brain 'microbleeds' after stroke increase risk for recurrence, study finds

Oct. 19 (UPI) -- Stroke victims who experience cerebral microbleeds during recovery are 50% more likely to suffer from a second cerebrovascular incident, a study published Monday by JAMA Neurology found.

In addition, patients with microbleeds in the frontal, occipital or parietal lobes of the brain have 2 1/2 times the risk for an ischemic stroke -- one that disrupts the flow of oxygen and blood to the brain -- causing potentially permanent damage, the data showed.

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Microbleeds are small amounts of bleeding in the brain visible only on magnetic resonance imaging scans.

Those with microbleeds also are more than four times as likely to suffer from intracerebral, or brain, bleeds.

These microbleeds should not impact whether stroke patients receive anti-coagulant or anti-platelet treatment, researchers said.

"Patients with stroke who have small ... brain bleeds or 'microbleeds' ... respond similarly to blood thinners as patients without microbleeds," study co-author Dr. Ashkan Shoamanesh told UPI.

"Our results support the continued use of blood thinners in patients with ischemic stroke who are incidentally found to have these lesions on imaging," said Shoamanesh, a stroke neurologist at Hamilton Health Sciences in Canada.

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Nearly 800,000 people in the United States have a stroke every year, with roughly one in four these being recurrent -- or second -- strokes, according to the U.S. Centers for Disease Control and Prevention.

Cerebral microbleeds occur in about one in three ischemic stroke patients, Shoamanesh and his colleagues said.

Historically, there have been concerns that the use of anticoagulant -- or blood-thinner -- therapy in those who have suffered a stroke with a subsequent microbleed, because the treatment can potentially increase brain bleeding, they said.

For this study, which evaluated nearly 3,700 ischemic stroke patients, 395 -- or 11% -- had evidence of brain microbleeds on MRI.

Those with a history of high blood pressure or who have had strokes impacting multiple arteries to the brain were about twice as likely to experience a microbleed, they said.

Stroke patients with microbleeds were 1 1/2 times as likely as others to experience a recurrent stroke, while those with strictly lobal microbleeds -- or bleeding in the lobes of the brain -- had a 150% higher risk for ischemic stroke, according to the researchers.

However, these microbleeds did not influence whether or not stroke patients responded well to treatment with prescription blood thinners or aspirin therapy, the researchers said.

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