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Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications
Koennecke HC.. Neurology, 2006-01-01
Topic: Risk, prevention and care in population studies
Objective To assess the potential role of cerebral microbleeds (CMB) in intracerebral hemorrhage (ICH), as indicators of cerebral small-vessel disease, and their possible implications for antithrombotic treatment. Methods The author reviewed literature published through July 2005 from electronic MEDLINE, PubMed, and hand searches. CMB prevalence analyses were performed for subjects without cerebrovascular disease, with ICH, and with ischemic cerebrovascular disease. Results Prevalence data from more than 5,200 subjects were analyzed. In elderly subjects without cerebrovascular disease, CMB prevalence is between 5% and 6%, associated with advanced age, while data are inconsistent with regard to CMB and chronic hypertension. CMB are prevalent in 68% of patients with spontaneous ICH and 40% of those with ischemic cerebrovascular disease. Cerebral microangiopathy (lacunes, leukoaraiosis) is associated with the highest prevalence (57%) of CMB among patients with ischemic stroke. In patients with suspected cerebral amyloid angiopathy (CAA) or Alzheimer disease, CMB are predominantly located in the cortical-subcortical area. Current data provide no evidence that CMB increase the risk of ICH among patients on antithrombotic treatment or those treated with thrombolysis for acute stroke. Conclusions Cerebral microbleeds might indicate a higher risk of future intracerebral hemorrhage and may be a marker of cerebral small-vessel disease and cerebral amyloid angiopathy. However, more prospective data are required in order to confirm these assumptions. Recommendations to guide antithrombotic treatment based on the detection of cerebral microbleeds are presently not justified.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Koennecke, H. C. (2006). Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications. Neurology. https://doi.org/10.1212/01.wnl.0000194266.55694.1e
Vancouver
Koennecke HC. Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications. Neurology. 2006. doi:10.1212/01.wnl.0000194266.55694.1e. PMID: 16434647.
BibTeX
@article{koennecke2006-16434647,
author = {Koennecke, H. C.},
title = {{Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications}},
journal = {Neurology},
year = {2006},
doi = {10.1212/01.wnl.0000194266.55694.1e},
pmid = {16434647},
url = {https://doi.org/10.1212/01.wnl.0000194266.55694.1e}
}
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Key findings
- Results Prevalence data from more than 5,200 subjects were analyzed.
- In elderly subjects without cerebrovascular disease, CMB prevalence is between 5% and 6%, associated with advanced age, while data are inconsistent with regard to CMB and chronic hypertension.
- Cerebral microangiopathy (lacunes, leukoaraiosis) is associated with the highest prevalence (57%) of CMB among patients with ischemic stroke.
- Conclusions Cerebral microbleeds might indicate a higher risk of future intracerebral hemorrhage and may be a marker of cerebral small-vessel disease and cerebral amyloid angiopathy.
Why it matters
This review found that cerebral microbleeds are common in people with spontaneous intracerebral hemorrhage and ischemic cerebrovascular disease, and in suspected cerebral amyloid angiopathy or Alzheimer's disease they are mostly in cortical-subcortical areas. Current data provided no evidence that microbleeds increase the risk of intracerebral hemorrhage in patients on antithrombotic treatment or thrombolysis, so this does not establish a treatment or prevention for Alzheimer's disease.
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Study details
- Participants5,200
- Evidence strengthLow
How this study scored 54/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 3 / 4 | 5,200 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 374 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 17.0 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 5 / 6 | Cited 21.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 11 other studies in this library |
| Still being cited | 2 / 4 | Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Hans‐Christian Koennecke: h-index 23 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Evangelisches Krankenhaus Königin Elisabeth Herzberge: institution h-index 67 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16434647) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 54 / 100 | — |
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