Related Experiment Video
Updated: Aug 18, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Is there a difference in risk factors for single and multiple symptomatic lesions in small vessel disease? What is
Aleksandra M Pavlovic1, Tatjana Pekmezovic, Jasna Zidverc-Trajkovic
1Institute of Neurology, Clinical Center of Serbia, Dr. Subotica 6, 11000 Belgrade, Serbia. dpavlovic@drenik.net
Insights
Multiple lacunar infarctions (MLI) in small vessel disease (SVD) are linked to hypertension and high homocysteine. Single lacunar infarctions (LI) are associated with younger age and family history of cardiovascular disease (CVD).
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Small vessel disease (SVD) is a significant cause of stroke and cognitive impairment.
- Traditional vascular risk factors (RF) are known contributors to SVD.
- However, the specific risk factor profiles for different SVD presentations remain unclear.
Purpose of the Study:
- To investigate whether distinct types of SVD, specifically single lacunar infarction (LI) versus multiple lacunar infarctions (MLI) with or without white matter lesions (WML), exhibit different vascular risk factor profiles.
- To identify unique associations between specific risk factors and SVD subtypes.
Main Methods:
- Analysis of 40 vascular risk factor parameters in 201 consecutive patients diagnosed with SVD via magnetic resonance imaging.
- Comparison of risk factor prevalence between patients with single LI and those with MLI (with or without WML).
Main Results:
- Multiple lacunar infarctions (MLI) were associated with a history of arterial hypertension, higher systolic and mean blood pressure (BP), hypotension, and elevated plasma homocysteine levels compared to single LI.
- Patients with single LI were younger, more frequently presented with clinically evident stroke, and had a positive family history of cardiovascular disease (CVD).
- Despite these differences, the identified risk factors suggest that similar underlying pathological processes contribute to both types of SVD.
Conclusions:
- Age and family history of CVD are positively correlated with SVD, particularly single LI.
- Further research into genetic factors is warranted to fully understand the development of different SVD lesion types.
Objectives/Purposes:
Small vessel disease (SVD) is associated with traditional vascular risk factors (RF). The aim of our study was to determine whether different SVD types, single lacunar infarction (LI) and multiple LI (MLI) with or without white matter lesions (WML), have different RF profiles.
Patients And Methods:
Forty RF parameters were analysed in 201 consecutive patients with magnetic resonance imaging finding of SVD.
Results:
History of arterial hypertension, higher systolic and mean blood pressure (BP) but also hypotension, and higher plasma homocysteine levels were more frequent in MLI compared to single LI patients (p<0.05). Patients with one LI were younger, more frequently had clinically evident stroke and family history of cardiovascular disease (CVD) (p<0.05). Significant difference between groups was found only in these RF, indicating that similar pathological processes led to both types of SVD.
Conclusion:
Positive correlation with age and family history of CVD necessitates further analyses of other factors, predominantly genetic, as the key to the answer why patients develop different lesions in SVD.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation