The term cerebral small vessel disease refers to a group of pathological processes
with various aetiologies that affect the small arteries, arterioles, venules, and
capillaries of the brain. Age-related and hypertension-related small vessel diseases
and cerebral amyloid angiopathy are the most common forms. The consequences of small
vessel disease on the brain parenchyma are mainly lesions located in the subcortical
structures such as lacunar infarcts, white matter lesions, large haemorrhages, and
microbleeds. Because lacunar infarcts and white matter lesions are easily detected
by neuroimaging, whereas small vessels are not, the term small vessel disease is frequently
used to describe the parenchyma lesions rather than the underlying small vessel alterations.
This classification, however, restricts the definition of small vessel disease to
ischaemic lesions and might be misleading. Small vessel disease has an important role
in cerebrovascular disease and is a leading cause of cognitive decline and functional
loss in the elderly. Small vessel disease should be a main target for preventive and
treatment strategies, but all types of presentation and complications should be taken
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