Most cerebral small vessel diseases have insidious onset, slow development, and early symptoms that are not obvious or relatively mild, often overlooked and delayed in treatment. However, with the development of neuroimaging, the detection rate of cerebral small vessel disease is increasing, and it has become an important cause of cognitive impairment, dementia, emotional disorders, and decreased life ability in the elderly population. Cerebral small vessel disease has attracted increasing attention. So, what is cerebral small vessel disease? What are the causes and clinical manifestations of it, and how can it be prevented?
1、 What is cerebral small vessel disease? Cerebral small vessel disease refers to the disease caused by lesions in small blood vessels with an inner diameter of less than 400 microns in the brain, mainly including lesions in small arteries, arterioles, capillaries, and venules. If we compare the brain to a tree crown, water is transported to each leaf through thick to thin branches, and the peripheral branches are the 'brain's small blood vessels'. Cerebral small blood vessels refer to the small perforating arteries and arterioles (diameter 40-200 microns), capillaries, and venules in the brain, which constitute the basic units of blood supply to brain tissue and play an important role in maintaining brain function. When these small blood vessels become diseased, such as blocked or ruptured, it can cause corresponding symptoms - this is cerebral small vessel disease.
2、 Clinical manifestations of cerebral small vessel disease
1. Dizziness and fatigue;
2. Cognitive impairment, mainly manifested as decreased attention, memory loss, and delayed response;
3. Abnormal gait, such as unstable walking or slow walking speed;
4. Unstable emotions, indifference, irritability, suspicion, etc;
5. Abnormal urination, such as frequent nighttime urination, increased urine volume, etc;
6. Difficulty swallowing, coughing, etc.
3、 The etiology of cerebral small vessel disease
1. Atherosclerosis is the most common cause, followed by cerebral amyloid angiopathy, hereditary cerebrovascular disease, inflammation or immune-mediated cerebral small vessel disease, venous collagenization disease, etc. Cerebral vessels caused by arteriosclerosis are also known as age-related or vascular risk factor related small vessel disease.
2. After damage to small blood vessels in the brain, ischemia and hypoxia occur in the brain tissue, affecting the blood-brain barrier and causing toxic substances to seep out into the surrounding brain tissue, resulting in toxic damage.
4、 Preventive measures for cerebral small vessel disease
The prevention of small vessel disease related to vascular risk factors mainly involves controlling the risk factors that cause cerebral vascular disease, including uncontrollable and controllable factors. Uncontrollable factors include age and family history, which are beyond control. Only controllable factors can be controlled, mainly including the following: 1. Hypertension. Patients with hypertension have a 4-8 times higher chance of developing cerebrovascular disease than those without hypertension, so controlling blood pressure is very important.
2. Hyperlipidemia, especially in patients with high LDL and cholesterol, is mainly caused by the formation of atherosclerotic plaque, which will cause vascular stenosis, but also fall off and cause cerebral infarction. Therefore, people with hyperlipidemia should take statin lipid-lowering drugs.
3. diabetes, diabetes mainly damages small blood vessels and microvessels, and then forms cerebral infarction or cerebral hemorrhage.
4. In terms of lifestyle, smoking can damage endothelial cells and is also a risk factor for cerebrovascular disease, so it is essential to quit smoking.
If there are multiple risk factors present simultaneously, it is necessary to take antiplatelet aggregation drugs, so the prevention of cerebral small vessel disease mainly requires comprehensive measures.
The above is an introduction about cerebral small vessel disease, hoping to help everyone.