International Psychogeriatrics
Volume 15, Supplement 1 - 2003
Pathophysiology of Cerebral Small Vessels in Vascular Cognitive Impairment
LEONARDO PANTONI AND MICHELA SIMONI
ABSTRACT. Cerebral small-vessel alterations play a central role in determining lesions of
subcortical structures and eventually may lead to cognitive impairment. Small-vessel diseases
are classified according to the pathological viewpoint. The most important ones are the changes
in small arteries and arterioles caused by prolonged hypertension. These small-vessel changes
may result in ischemic damage to the brain parenchyma and blood-barrier alterations. Both
mechanisms are thought to contribute to the occurrence of white-matter changes and lacunar
infarcts. Modern magnetic resonance techniques such as diffusion, perfusion, and spectroscopy
may allow the in vivo study of the pathophysiology of small-vessel diseases and the consequences
on the brain parenchyma.
