Clinical significance of cerebral microbleeds in patients with germinoma who underwent long-term follow-up

Abstract Purpose This study identified the factors affecting cerebral microbleed (CMBs) development. Moreover, their effects on intelligence and memory and association with stroke in patients with germinoma who had long-term follow-up were evaluated. Methods Patients histologically and clinically diagnosed with and treated for germinoma were included in this analysis. These patients were evaluated cross-sectionally, with a focus on CMBs on susceptibility-weighted magnetic resonance imaging (SWI) and intelligence and memory. Results The follow-up period was from 32 to 412 (median: 175.5) months. In total, 46 (72%) patients had CMB. The total number of CMBs was 523 (8.1 per patient). Patients with recurrence had a significantly higher number of CMBs based on analysis of covariance adjusted for intervals from the initial treatment to the acquisition of magnetic resonance imaging images. ༴he patients were classified into the CMB-high and CMB-low groups with the median number of CMB. Patients with a high CMB had a lower processing speed score than those with a low CMB. Before SWI acquisition and during the follow-up periods, eight strokes occurred in four patients. Greater than 15 CMBs were found on SWI in all four patients. Meanwhile, 51 patients with < 14 CMBs did not experience stroke. Conclusion Patients with a longer time from treatment initiation had a high number of CMBs. Further, the number of CMBs increased over time, and recurrence was a significant risk factor of CMB development. Finally, the increased number of CMBs was related to the decline in process speed and stroke onset.