Causes Of Small Cerebral Ischemic Lesions

Small cerebral ischemic lesions are commonly associated with hyaline degeneration of small cerebral arteries caused by hypertension. When blood vessels remain under high pressure for prolonged periods, the vessel walls thicken and develop a glass-like appearance. This thickening can narrow or even completely block the vessel lumen. Once the lumen becomes narrowed or occluded, blood flow to the supplied area of the brain decreases, potentially leading to tissue infarction and the formation of a small ischemic lesion.

Key Factors Contributing To Small Ischemic Lesions

Arteriosclerosis And Vascular Changes

One major cause is arteriosclerosis, a condition in which the arteries become thickened and lose elasticity. Additionally, the inner lining of blood vessels can be damaged by high blood pressure, leading to the formation of plaque deposits. These plaques are similar to scale buildup inside water pipes. When these plaques are not firmly attached to the vessel wall, small fragments can break off and travel through the bloodstream.

Embolism From Dislodged Plaques

Once dislodged, these tiny plaque fragments can reach smaller blood vessels further along the circulatory system. If the size of the plaque exceeds the diameter of the vessel, it may cause a blockage. This obstruction prevents adequate blood flow to the brain tissue supplied by that vessel, resulting in localized tissue damage or infarction, which manifests as small ischemic or infarct lesions in the brain.

Other Risk Factors

In addition to hypertension, other systemic conditions such as diabetes mellitus, dyslipidemia, and elevated levels of homocysteine have been linked to the development of small cerebral ischemic lesions. These conditions contribute to vascular damage and impaired blood flow, increasing the risk of microvascular complications in the brain.