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When no evidence of small vessel disease is found on histologic examination, an embolic cause is assumed, either artery-to-artery embolism or cardioembolism. In one recent series, 25% of patients with clinical radiologically defined lacunes had a potential cardiac cause for their strokes.
The most common presentation of cerebrovascular disease is an ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke. [2] Hypertension (high blood pressure) is the most important contributing risk factor for stroke and cerebrovascular diseases as it can change the structure of blood vessels and result in atherosclerosis . [ 5 ]
Microangiopathy (also known as microvascular disease, small vessel disease (SVD) or microvascular dysfunction) is a disease of the microvessels, small blood vessels in the microcirculation. [1] It can be contrasted to macroangiopathies such as atherosclerosis , where large and medium-sized arteries (e.g., aorta , carotid and coronary arteries ...
Diseases that may form thrombi in the small vessels include (in descending incidence): lipohyalinosis (build-up of fatty hyaline matter in the blood vessel as a result of high blood pressure and aging) and fibrinoid degeneration (stroke involving these vessels is known as a lacunar stroke) and microatheroma (small atherosclerotic plaques). [51]
Lipohyalinosis is a cerebral small vessel disease affecting the small arteries, arterioles or capillaries in the brain.Originally defined by C. Miller Fisher as 'segmental arteriolar wall disorganisation', it is characterized by vessel wall thickening and a resultant reduction in luminal diameter.
Brain ischemia has been linked to a variety of diseases or abnormalities. Individuals with sickle cell anemia, compressed blood vessels, ventricular tachycardia, plaque buildup in the arteries, blood clots, extremely low blood pressure as a result of heart attack, and congenital heart defects have a higher predisposition to brain ischemia in comparison to the average population.
A microinfarct is a microscopic stroke generally ranging between 0.1 millimeter and 1 millimeter in size. [1] [2] Microinfarcts can be found in 25-50% of all elderly deceased persons. Microinfarcts may be the second most important cause of dementia, after Alzheimer's disease. [3] [4]
A history of stroke increases the risk of developing dementia by around 70%, and recent stroke increases the risk by around 120%. [13] Brain vascular lesions can also be the result of diffuse cerebrovascular disease , such as small vessel disease .