Microsangrados cerebrales múltiples en paciente con hipertensión mal controlada. Un nuevo marcador de vasculopatía hipertensiva

Brain microbleeds are small dot-like lesions appearing as hyposignal on gradient echo T2* MR sequences. They represent microscopic areas of old hemosiderin deposits. They are frequent in the setting of symptomatic cerebrovascular disease and also in older healthy people, which suggests a link with arterial hypertension. Their use as diagnostic or prognostic biomarkers remains uncertain. The appearance of these microbleedings and increasing use of Magnetic resonance imaging (MRI) in the clinical practice causes many clinical dilemmas. We report the case of a woman with difficult to control hypertension, who was admitted with bilateral simultaneous cerebral hemorrhage, multiple microbleedings being observed in the cerebral magnetic resonance. We discuss the identification and meaning of these hemorrhagic lesions.