5 Interesting Facts of Cerebral small vessel disease
- Slowly developing neurologic process affecting small cerebral arterioles, capillaries, and sometimes venules; mostly occurs as a consequence of arteriosclerosis
- 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)
- Clinical similarity to moyamoya in the sudden onset of stroke symptoms
- Patient characteristics frequently found in cerebral small vessel disease are older age, diabetes, and particularly hypertension
- 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
