The Prevalence of Microhemorrhage on Gradient-echo Magnetic Resonance Imaging in Acute Lacunar Infarction

Introduction: Microhemorrhages seen on gradient-echo magnetic resonance imaging are thought to be a manifestation of small-vessel disease. It was the aim of our study to evaluate the prevalence of microhemorrhage for patients presenting with acute lacunar infarction. Methods: We obtained gradient-echo and diffusion-weighted magnetic resonance imaging as part of the acute stroke workup in 46 patients presenting with lacunar infarction. Results: Gradient-echo magnetic resonance imaging was abnormal in 24 of 46 (52%) patients. Microhemorrhage was seen in 21 patients (46%), 2 patients had multiple microhemorrhages and a frank hemorrhage, and 3 patients had frank hemorrhage in the absence of microhemorrhage. Prior symptomatic stroke was the only significant risk factor for the presence of microhemorrhages. Conclusion: Microhemorrhages are present in approximately half of patients with lacunar infarcts and appear to be a marker of severity of small-vessel disease.