Cerebral small vessel disease

5 Interesting Facts of Cerebral small vessel disease 

  1. Slowly developing neurologic process affecting small cerebral arterioles, capillaries, and sometimes venules; mostly occurs as a consequence of arteriosclerosis 
  2. Core mechanism underlying brain injury usually is assumed to be ischemia, which occurs as a result of arteriolar narrowing or occlusion (eg, vasospasm, impaired autoregulation, hypotension) 
  3. Clinical similarity to moyamoya in the sudden onset of stroke symptoms
  4. Patient characteristics frequently found in cerebral small vessel disease are older age, diabetes, and particularly hypertension 
  5. Cerebral small vessel disease is distinguished from moyamoya by specific findings on imaging
    • On MRI, findings indicative of cerebral small vessel disease include acute lacunar infarcts or hemorrhages, lacunes (ie, fluid-filled cavities thought to reflect old infarcts), white matter hyperintensities, visible perivascular spaces, microbleeds, and brain atrophy

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