SynthesisNeurology2016
Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis.
Registry-linked trialAbstract readMeta-Analysis
In one paragraph
Synthesis in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04504864 (Low-dose Aspirin Therapy in Patients With Non-Cardioembolic Ischemic Stroke and Microbleeds), which is not on this map. Cited by 72 papers, 12 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 12 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Low-dose Aspirin Therapy in Patients With Non-Cardioembolic Ischemic Stroke and Microbleeds
Who cites it
72 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Cerebral Small-Vessel Disease Markers on Magnetic Resonance Imaging as Predictors of Recurrent Vascular Events and Death in Ischemic Stroke: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Comparative Diagnostic and Prognostic Performance of SWI and T2-Weighted MRI in Cerebral Microbleed Detection Following Acute Ischemic Stroke: A Meta-Analysis and SPOT-CMB Study.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Association between pulse wave velocity and cerebral microbleeds: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- Prevalence, Risk Factors, and Clinical Outcomes of New Cerebral Microbleeds After Intravenous Thrombolysis in Acute Ischemic Stroke: a Systematic Review and Meta-analysis.Clinical neuroradiology · 2024Pooled it
- Chronic high-altitude exposure and the epidemiology of ischaemic stroke: a systematic review.BMJ open · 2022Pooled it
- Prevalence of cerebral amyloid angiopathy: A systematic review and meta-analysis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Pooled it
- Use of anticoagulant therapy and cerebral microbleeds: a systematic review and meta-analysis.Journal of neurology · 2021Pooled it
- Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.The Lancet. Neurology · 2019Pooled it
- Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury: A Systematic Review and Meta-analysis.JAMA neurology · 2019Pooled it
- Clinical significance of cerebral microbleeds on MRI: A comprehensive meta-analysis of risk of intracerebral hemorrhage, ischemic stroke, mortality, and dementia in cohort studies (v1).International journal of stroke : official journal of the International Stroke Society · 2018Pooled it
- Pooled it
- Antithrombotic treatment after stroke due to intracerebral haemorrhage.The Cochrane database of systematic reviews · 2017Pooled it
- Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk.Scientific reports · 2021Trial
- Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial.The Lancet. Neurology · 2019Trial
- Microbleeds in the Secondary Prevention of Small Subcortical Strokes Trial: Stroke, mortality, and treatment interactions.Annals of neurology · 2017Trial
- Lacunar stroke with and without chronic imaging biomarkers of small vessel disease: clinical profiles and stroke etiology.Frontiers in neurology · 2026Observational
- Obstructive Sleep Apnea and Cerebral Microbleeds in Middle-Aged and Older Adults.JAMA network open · 2025Article
- Development and Internal Validation of a Clinical Imaging-Based Stroke Prediction Model in a Community Cohort.Journal of the American Heart Association · 2025Article
- Development of cerebral microhemorrhages in a mouse model of hypertension.Journal of neuroinflammation · 2025Article
- Prevalence and Risk Factors of Cerebral Microbleeds among Egyptian Patients with Acute Ischemic Stroke.Neuroepidemiology · 2025Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Duncan WilsonFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Andreas CharidimouFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Gareth AmblerFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Zoe V FoxFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Simone GregoireFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Phillip RaysonFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Toshio ImaizumiFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Felix FluriFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Hiromitsu NakaFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Solveig HorstmannFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Roland VeltkampFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Peter M RothwellFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Vincent I H KwaFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Vincent ThijsFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Yong-Seok LeeFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Young Dae KimFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Yining HuangFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Ka Sing WongFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
Hans Rolf JägerFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK.
David J WerringFrom the Stroke Research Centre (D.W., A.C., S.G., P.R., D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery; Department of Statistical Science (G.A.) and Biomedical Research Centre (Z.V.F.), UCL, London, UK; Department of Neurosurgery (T.I.), Kushiro City General Hospital, Hokkaido, Japan; Department of Neurology (F.F.), University Hospital Würzburg, Germany; Department of Neurology (H.N.), Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Neurology (S.H.), University of Heidelberg, Germany; Department of Stroke Medicine (R.V.), Division of Brain Sciences, Imperial College London; Nuffield Department of Clinical Neurosciences (P.M.R.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (V.I.H.K.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Department of Neurology (V.T.), Austin Health and Melbourne Brain Center, University of Melbourne, Australia; Department of Neurology (Y.-S.L.), Seoul National University Boramae Medical Center; Department of Neurology (Y.D.K.), Yonsei University College of Medicine, Seoul, Korea; Department of Neurology (Y.H.), Peking University First Hospital, Beijing, China; Division of Neurology (K.S.W.), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; and Lysholm Department of Neuroradiology (H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK. d.werring@ucl.ac.uk.
Funding
Wellcome Trust 095626
Abstract
objectiveTo determine associations between cerebral microbleed (CMB) burden with recurrent ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA.
methodsWe identified prospective studies of patients with IS or TIA that investigated CMBs and stroke (ICH and IS) risk during ≥3 months follow-up. Authors provided aggregate summary-level data on stroke outcomes, with CMBs categorized according to burden (single, 2-4, and ≥5 CMBs) and distribution. We calculated absolute event rates and pooled risk ratios (RR) using random-effects meta-analysis.
resultsWe included 5,068 patients from 15 studies. There were 115/1,284 (9.6%) recurrent IS events in patients with CMBs vs 212/3,781 (5.6%) in patients without CMBs (pooled RR 1.8 for CMBs vs no CMBs; 95% confidence interval [CI] 1.4-2.5). There were 49/1,142 (4.3%) ICH events in those with CMBs vs 17/2,912 (0.58%) in those without CMBs (pooled RR 6.3 for CMBs vs no CMBs; 95% CI 3.5-11.4). Increasing CMB burden increased the risk of IS (pooled RR [95% CI] 1.8 [1.0-3.1], 2.4 [1.3-4.4], and 2.7 [1.5-4.9] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively) and ICH (pooled RR [95% CI] 4.6 [1.9-10.7], 5.6 [2.4-13.3], and 14.1 [6.9-29.0] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively).
conclusionsCMBs are associated with increased stroke risk after IS or TIA. With increasing CMB burden (compared to no CMBs), the risk of ICH increases more steeply than that of IS. However, IS absolute event rates remain higher than ICH absolute event rates in all CMB burden categories.
Indexed as
Brain IschemiaCerebral HemorrhageHumansRecurrenceRiskStroke
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Read underepoch 390
Registered trials
NCT04504864ClinicalTrials.gov
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