Sousanidou Anastasia, Tsiptsios Dimitrios, Christidi Foteini, Karatzetzou Stella, Kokkotis Christos, Gkantzios Aimilios, Bairaktaris Chrisostomos, Karapepera Vaia, Bebeletsi Paschalina, Karagiannakidou Ioanna, Marinidis Marinos, Aggelousis Nikolaos, Vadikolias Konstantinos
Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece.
Neurol Int. 2023 Feb 1;15(1):188-224. doi: 10.3390/neurolint15010014.
Stroke constitutes a major cause of functional disability and mortality, with increasing prevalence. Thus, the timely and accurate prognosis of stroke outcomes based on clinical or radiological markers is vital for both physicians and stroke survivors. Among radiological markers, cerebral microbleeds (CMBs) constitute markers of blood leakage from pathologically fragile small vessels. In the present review, we evaluated whether CMBs affect ischemic and hemorrhagic stroke outcomes and explored the fundamental question of whether CMBs may shift the risk-benefit balance away from reperfusion therapy or antithrombotic use in acute ischemic stroke patients. A literature review of two databases (MEDLINE and Scopus) was conducted to identify all the relevant studies published between 1 January 2012 and 9 November 2022. Only full-text articles published in the English language were included. Forty-one articles were traced and included in the present review. Our findings highlight the utility of CMB assessments, not only in the prognostication of hemorrhagic complications of reperfusion therapy, but also in forecasting hemorrhagic and ischemic stroke patients' functional outcomes, thus indicating that a biomarker-based approach may aid in the provision of counseling for patients and families, improve the selection of more appropriate medical therapies, and contribute to a more accurate choice of patients for reperfusion therapy.
中风是导致功能残疾和死亡的主要原因，其患病率呈上升趋势。因此，基于临床或影像学标志物及时准确地预测中风预后，对医生和中风幸存者都至关重要。在影像学标志物中，脑微出血（CMB）是病理性脆弱小血管血液渗漏的标志物。在本综述中，我们评估了CMB是否会影响缺血性和出血性中风的预后，并探讨了一个基本问题，即CMB是否可能使急性缺血性中风患者的风险效益平衡偏离再灌注治疗或抗栓治疗的使用。我们对两个数据库（MEDLINE和Scopus）进行了文献综述，以确定2012年1月1日至2022年11月9日期间发表的所有相关研究。仅纳入以英文发表的全文文章。共检索到41篇文章并纳入本综述。我们的研究结果强调了CMB评估的作用，不仅在于预测再灌注治疗的出血并发症，还在于预测出血性和缺血性中风患者的功能预后，从而表明基于生物标志物的方法可能有助于为患者及其家属提供咨询，改进更合适的药物治疗选择，并有助于更准确地选择适合再灌注治疗的患者。
