Incidental asymptomatic intracerebral hemorrhages and risk of subsequent cardiovascular events and cognitive decline in elderly persons

J Stroke Cerebrovasc Dis. 2015 Jun;24(6):1217-22. doi: 10.1016/j.jstrokecerebrovasdis.2015.01.020. Epub 2015 Apr 20.


Background: The long-term prognostic significance of incidental asymptomatic intracerebral hemorrhages (aICHs) detected on brain magnetic resonance imaging (MRI) is unknown.

Methods: We analyzed clinical and baseline MRI data from the cohort of 5888 study participants aged 65 years and older recruited in the Cardiovascular Health Study from 4 US communities. We identified participants who had aICHs on MRI and selected 3 age- and gender-matched controls without aICHs. We compared the rates of cardiovascular events using logistic regression analysis including incident myocardial infarction, stroke, and death between those with and without aICHs.

Results: A total of 23 participants had aICHs classified as acute (n = 3), subacute (n = 4), and chronic (n = 16). During 14 years of follow-up, the risk of incident stroke (relative risk [RR], .6; 95% confidence interval [CI], .2-2.0), myocardial infarction (RR, .3; 95% CI, .06-1.4), and death (RR, .6; 95% CI, .2-1.7) was not different between participants with aICHs compared with controls (n = 69). There was no difference between the 2 groups with regard to time to ischemic stroke or time to death by Kaplan-Meier analysis.

Conclusions: The risks of stroke, myocardial infarction, and death were similar between persons with aICHs detected on MRI compared with age- and gender-matched controls.

Keywords: Intracerebral hemorrhage; asymptomatic; cardiovascular events; epidemiologic study; stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain / pathology*
  • Case-Control Studies
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / pathology
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology
  • Female
  • Humans
  • Incidence
  • Magnetic Resonance Imaging
  • Male
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Prognosis
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology