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J Korean Neurol Assoc. 2014;32(2):82-87.
- The Association Between Hypertension and Cerebral Microbleeds in
Patients With CADASIL
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Jung Seok Lee
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Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
- 카다실 환자에서 고혈압과 뇌미세출혈의 연관성
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이정석, 박선우 송숙근 최재철 강사윤 강지훈
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제주대학교 의학전문대학원 제주대학교병원 신경과
- Abstract
- Background
Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)
is an inherited microangiopathy that is caused by mutations in the Notch3 gene. Typical findings from magnetic
resonance imaging (MRI) include multiple subcortical lacunae, extensive white-matter change, and multiple cerebral
microbleeds (CMBs). CMBs are indicative of bleeding-prone microangiopathy. The rate of intracerebral hemorrhage in
CADASIL is higher in Asian patients than in Caucasian patients. However, CMBs have not been thoroughly evaluated in
Asian patients. We performed a detailed analysis of the frequency and distribution pattern of CMBs and assessed
whether vascular risk factors exert an independent effect on CMBs in Asian CADASIL patients.
Methods
The study population comprised 60 patients who underwent brain MRI, including T2*-weighted gradient-echo
sequences. Demographic factors, vascular risk factors, and MRI findings were compared between CADASIL patients
with and without CMBs. The impact of vascular risk factors on CMBs, lacunae, and white-matter hyperintensities
(WMHs) was assessed by logistic regression analysis.
Results
CMBs, which were detected in 34 (56.7%) patients, exhibited a significant predilection for the thalamus (46.7%),
subcortical-cortical region (35.0%), and basal ganglia (31.7%). Hypertension, lacunae, and white-matter lesions were
more common in patients with CMBs. Hypertension was an independent risk factor for CMBs, lacunae, and WMHs in
patients with CADASIL.
Conclusions
This study found that CMBs tended to occur in hypertensive patients with CADASIL. Further studies
should focus on elucidating the association between reduced blood pressure and the number of CMBs. Key Words: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL),
Cerebral microbleeds (CMBs), Hypertension
Keywords :
- 초록
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