Multiple cerebral microbleeds: MRI marker of a diffuse hemorrhage-prone state.

BACKGROUND: Recent reports have indicated that cerebral microbleeds (CMBs) detected on gradient-echo (GRF) magnetic resonance imaging may be a risk factor for therapy related intracranial hemorrhages (ICHs).

CASE DESCRIPTION: The authors describe 3 patients with multiple CMBs in whom ICHs occurred either after tissue plasminogen activator administration or after the initiation of antiplatelet therapy. Hemorrhages occurred in brain areas with normal appearances on GRE imaging and remote from the CMBs.

CONCLUSION: Multiple CMBs may signal a diffuse hemorrhage-prone vasculopathy.