Cerebral microhaemorrhage

Cerebral microhaemorrhages, or microbleeds, are small focal cerebral haemorrhages, often only visible on certain susceptible MRI sequences. There are frequently seen in the elderly, as hypertension and cerebral amyloid are both common. A number of additional aetiologies are recognised including: 

Radiographic features

They are best seen on susceptibility weighted T2* sequences such as gradient echo (GRE), and susceptibility weighted imaging (SWI), and show up as very conspicuous punctate regions of signal drop out with blooming artifact. This blooming grossly overestimates the size of the lesions, and they are usually inapparent on other sequences. As such the sometimes used definition of 5 mm or less in size is difficult as it is sequence dependent, and should certainly not be applied to sequences which exhibit blooming. 

Differential diagnosis

  • artificial heart valve metallic emboli (very rare)
  • pneumocephalus (very rare without proceeding surgery) 2
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Article Information

rID: 4560
Section: Gamuts
Synonyms or Alternate Spellings:
  • Microbleeds
  • Cerebral microhemorrhages

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Cases and Figures

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    Case 1: cerebral amyloid angiopathy
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    Case 2: chronic hypertension
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    Case 3: radiotherapy
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    Case 4: cavernous malformations
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