Cerebral Microbleeds in Ischemic Stroke Patients on Warfarin Treatment

Background and Purpose - Cerebral microbleeds (CMBs) are known to be indicative of bleeding prone microangiopathy. Little is known about its significance in anticoagulated patients. We aimed to determine the frequency of CMBs in ischemic stroke patients on warfarin treatment. Methods - A total of 141 ischemic stroke patients on warfarin therapy were enrolled in this study. One hundred five patients with similar demographic features who do not use warfarin were chosen as controls. We compared vascular risk factors and radiological findings including CMBs and leukoaraiosis between the groups. Results - CMBs on gradient-echo MRI (GE-MRI) were found in 31 patients (22%) and 17 controls (16%) and there was not a significant difference between 2 groups (P = 0.25). Study patients with CMBs were older than patients without CMBs (P = 0.04) and frequency of leukoaraiosis was significantly higher (P = 0.008). Mean duration of warfarin treatment was not different between the patients with and without CMBs (P = 0.83). Conclusion - Although patients with CMBs were older and had more leukoaraiosis the impact of warfarin treatment on CMBs is still controversial. (Stroke. 2009; 40: 3638-3640.)