Best et all reported 2 scores for evaluating a patient taking antithrombotic therapy for cerebrovascular disease. One score predicts intracerebral hemorrhage (ICH) and the other ischemic stroke (IS). The authors are from multiple institutions from around the world.
MICON stands for Microbleeds International Collaborative Network.
Patient selection: antithrombotic therapy for previous stroke or transient ischemic attach (TIA)
Outcome: intracerebral hemorrhage (ICH)
Parameters:
(1) number of cerebral microbleeds
(2) T2* GRE (gradient-recalled echo) sequence used
(3) age in years
(4) ethnic population
(5) ischemic stroke before presenting stroke or TIA
(6) previous intracranial hemorrhage
(7) antithrombotic therapy
|
Parameter
|
Finding
|
Points
|
|
number of cerebral microbleeds
|
0
|
0
|
|
|
1 to 4
|
3
|
|
|
5 to 10
|
5
|
|
|
11 to 19
|
6
|
|
|
>= 20
|
9
|
|
T2* GRE sequence used
|
no
|
0
|
|
|
yes
|
2
|
|
age in years
|
< 70 years
|
0
|
|
|
70 to 79 years
|
3
|
|
|
>= 80 years
|
4
|
|
ethnic population
|
East-Asian
|
2
|
|
|
other
|
0
|
|
previous ischemic stroke
|
no
|
0
|
|
|
yes
|
1
|
|
previous intracranial hemorrhage
|
no
|
0
|
|
|
yes
|
5
|
|
antithrombotic therapy
|
antiplatelet only
|
1
|
|
|
warfarin or vitamin K antagonist
|
1
|
|
|
DOAC
|
0
|
|
|
other
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of intracranial hemorrhage.
|
Score
|
5-Year Risk ICH
|
|
0 to 4
|
1%
|
|
5 to 7
|
2.5%
|
|
>= 8
|
6.5%
|
Performance:
• The area under the ROC curve is 0.73 (optimism-adjusted).
