Research progress on the relationship between antiplatelet drugs and cerebral microbleeds / 中华神经科杂志

ABSTRACT

Cerebral microbleeds (CMBs) are a subclinical terminal microvascular disease in which the blood exudates or leaks out from the tiny blood vessels and the small lesions were formed by the deposition of hemosiderin in the brain tissue. The pathogenesis of cerebral microbleeds is different depending on the location, with lobar CMBs attributed to cerebral amyloid angiopathy (CAA), while cerebrovascular diseases caused by hypertension are an important cause of deep and subtentorium CMBs. The prevalence of CMBs in stroke patients is high, especially in patients with ischemic stroke treated with oral antiplatelet drugs, and long-term (>5 years) treatment may be related to CMBs and intracerebral hemorrhage (ICH) events. At the same time, a certain burden of microbleeds may cause risk of ICH in the future, but whether the bleeding risk of antiplatelet treatment overweighs the clinical benefit of antithrombotic therapy remains unclear. How to better instruct antiplatelet therapy in patients with ischemic stroke warrants further clinical investigations.