To investigate the clinical characteristics of cerebral microbleeds in patients with moyamoya disease (MMD).

This study retrospectively included 222 consecutive patients with MMD in our hospital from October 2014 to December 2017. The microbleeds was identified by MRI T2 or SWI. The associated risk factors, image features and other clinical characteristics were compared between microbleed-positive group and microbleed-negative group.

56 microbleeds were detected in 38 MMD patients, with 44 (78.6%) located in the supratentorial lobe area and the other 12 (21.4%) located in the deep supratentorial area. The mean age of microbleed-positive group was significantly higher than that of microbleed-negative group (P = 0.006); The incidence of hemorrhagic stroke in microbleed-positive group was significantly higher than that in microbleed-negative group (P=0.029). The percentage of patients with normal cerebral perfusion in microbleed-positive group was significantly higher than that in microbleed-negative group (P＜0.001), while the percentage of patients of the preinfarction period stage Ⅲ in microbleed-positive group was significantly lower than that in microbleed-negative group (P=0.010). The results of multivariate logistic regression analysis showed that the hemorrhagic MMD (OR=2.832, 95%CI 1.098-7.304, P=0.031) and the preinfarction period stage (OR=0.671, 95%CI 0.486-0.927, P=0.016) were associated with the occurrence of cerebral microbleeds in MMD patients.

Cerebral microbleeds of MMD usually occurs in the supratentorial lobe area. The clinical category of MMD and the preinfarction period stage were independently associated with the occurrence of cerebral microbleeds in MMD patients.