[Actual problems of brain pathology in cerebral microangiopathy]

Area of Science:

• Neurology
• Neuroimaging
• Vascular Neurology

Background:

• Cerebral microangiopathy, a small vessel disease, causes diffuse brain changes (encephalopathy).
• In Russian literature, this is termed dyscirculatory encephalopathy (DE).
• Arterial hypertension is the primary cause, followed by cerebral amyloid angiopathy and CADASIL.

Purpose of the Study:

• To analyze the causes of DE hyperdiagnosis in Russia.
• To differentiate DE from stroke consequences.
• To propose improved terminology for encephalopathy in small vessel disease.

Main Methods:

• Clinical assessment of cognitive impairment and gait disorders.
• Neuroimaging analysis (MRI) for white matter hyperintensity and lacunar infarcts.
• Literature review and terminology analysis.

Main Results:

• Diagnosis relies on combining clinical symptoms with MRI findings.
• Overdiagnosis of DE is a concern in Russia.
• Differential diagnosis from recurrent stroke effects is crucial.

Conclusions:

• The term 'microangioencephalopathy' is proposed.
• This term better reflects the brain's morphological changes in small vessel disease.
• Standardized terminology is needed for accurate diagnosis and research.