Aspirin Linked to Brain Microbleeds

In an article published in, a Dutch study found an increase in occurrence of microbleeding episodes in the brains of people who regularly take aspirin.

Magnetic resonance imaging (MRI) exams of 1,062 people showed a 70 percent increase in frequency of microbleeds in those who take aspirin or carbasalate. On the other hand, the researchers found no increased frequency of microbleeds in people taking clot-preventing drugs that act in different ways such as heparin.

This is according to an online report in the Archives of Neurology from physicians of Erasmus MC University Medical Center in Rotterdam. The research is expected to be published in the June issue of the journal.

Both aspirin and its close chemical relative carbasalate calcium are taken to reduce the risk of heart problems such as heart attack and stroke. Both drugs prevent clotting by acting against the platelets.

Dr. Steven M. Greenberg, a professor of neurology at Harvard Medical School, and director of the Hemorrhagic Stroke Research Program at Massachusetts General Hospital, says the report "adds information to a still unfolding medical story about the causes and effects of microbleeds."

"They found an association between taking antiplatelet medications and having microbleeds. That is not proof that the antiplatelet medications are causing the microbleeds. People typically are given antiplatelet medication because they have more cardiovascular risk factors, which are associated with microbleeds. They tried to adjust for those risk factors, but that doesn’t prove that taking the medications causes the microbleeds."

Greenberg adds that, "it is not clear at this point what significance we can attach to seeing microbleeds."

Some studies showed a link between microbleeds and an increased risk of major bleeding incidences in the brain. However, only small numbers of people were involved in those studies.

There is also some data suggesting that microbleeds are linked to reduced brain function, but how they figure in the equation is yet to be determined because "hey tend to travel together with other kinds of small-vessel brain disease," Greenberg said.

According to Greenberg "It’s not clear at this point whether microbleeds are doing any substantial harm to the brain, but we do know that antiplatelet drugs help prevent heart attacks and strokes."

What the study gives "is a little bit of a warning for us to think about antiplatelet drug therapy as a risk for hemorrhagic damage to the brain," he adds.

Thus, it can’t tell physicians yet about who should be prescribed antiplatelet medications and who should not, says Greenberg.

"It’s important not to overreact until we are sure of what gives people the best combination of benefit without much risk," he said.



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