Figure 6.

A potential new clinical paradigm of the future role of neuroimaging markers of small vessel disease and blood/genetic biomarkers to predict intracerebral hemorrhage (ICH) by guiding stratified antithrombotic treatment decisions. In this scenario, a combination of imaging markers could be used to assess the relative balance of risk for future ischemic stroke or ICH, informing therapeutic decisions as well as potentially evaluating treatment effects and monitoring disease progression. Neuroimaging modalities and findings with potential clinical implications include: (A) cerebral microbleeds on axial T2*-weighed gradient-recalled echo or susceptibility-weighted imaging; (B) white matter changes on axial T2-weighted MRI; (C) amyloid-b load on PET images using radioligands (e.g., Pittsburgh compound B); and (D) small acute ischemic lesions (possibly cerebral microinfarcts) on axial diffusion-weighted images.