Small Vessel Ischemic Disease

Small vessel ischemic disease

Microvascular ischemic disease is a term that’s used to describe changes to the small blood vessels in the brain. Changes to these vessels can damage white matter — the brain tissue that contains nerve fibers and serves as the connection point to other parts of the brain.

Small vessel ischemic disease is very common in older adults. If left untreated, it can contribute to mental decline, strokes, walking and balance problems, and dementia.

Microvascular ischemic disease is also called:

Small vessel ischemic disease
Cerebral small vessel disease

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If you’re concerned about your risks for microvascular ischemic disease, or you’ve had symptoms, see your doctor. The main test used to diagnose this condition is magnetic resonance imaging (MRI).

An MRI uses strong magnets and radio waves to create detailed pictures of your brain. Microvascular ischemic disease can appear on an MRI in a few different ways:

small strokes (lacunar infarcts)
white matter lesions that show up as bright spots on the scan (white matter hyperintensities)
bleeding from small blood vessels in the brain (cerebral microbleeds)

Signs And Symptoms

Microvascular ischemic disease can be mild, moderate, or severe.

Many older adults — especially those with a mild form of the disease — have no symptoms, even though there are areas of damage in the brain. This is called “silent” disease. In one study, up to 20 % Trusted Source of healthy elderly people had silent damage in their brain, most of which was caused by small vessel disease.

Even though you might not notice any symptoms, you may have subtle changes in your thinking and physical abilities.

More severe small vessel disease can cause symptoms like these:

loss of thinking skills (cognitive impairment)
problems with walking and balance
depression

If small vessel disease causes a stroke, symptoms can include:

numbness or weakness, especially on one side of the body
sudden confusion
trouble speaking or understanding
vision loss in one or both eyes
dizziness
loss of balance or coordination
sudden, severe headache

A stroke is a medical emergency that needs to be treated right away.

Treatment options

Treatment generally involves managing the risk factors that contribute to small blood vessel damage in the brain. Which treatment strategy your doctor recommends will depend on your specific risk factors, but it might include:

Lowering your blood pressure with diet, exercise, weight loss, and medication. The goal for people age 60 and over is a systolic blood pressure (the top number) below 150.
Lowering your cholesterol level with diet, exercise, and statin drugs if needed.
Taking B vitamins to lower homocysteine levels. Homocysteine is an amino acid that at high levels has been linked to atherosclerosis and blood clots.
Taking aspirin or blood thinning drugs to prevent strokes.
Quitting smoking.

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