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In such a situation, it is a good approach to consider risks/benefits of anticoagulants for the individual patient and alternatives to life-long anticoagulation if possible (see Atrial Fibrillation part of this website as an example). They are commonly seen on MRIs obtained for unrelated complaints. Brain microbleeds are particularly important when found in patients who need strong blood thinner medications ( anticoagulants) for common conditions such as atrial fibrillation as anticoagulants increase the risk of potentially fatal brain bleeds. Large scale studies show that about one fifth of otherwise healthy population over 45 years of age have at least one brain microbleed. There is no specific treatment for microbleeds, the aim is to prevent the progression of the underlying small vessel disease (hypertension or cerebral amyloid angiopathy) and most importantly to adjust medical treatment to prevent potentially fatal hemorrhagic strokes. In that sense, even if the microbleeds are silent, they are markers of higher bleeding risk in both asymptomatic individuals and cerebral hemorrhage survivors.

The small vessel diseases that result in microbleeds also cause larger brain bleeds. Conceptually, brain microbleeds can be thought as very tiny amounts of blood (less than a drop) getting out of brain small vessels.