Does pathology of small venules contribute to cerebral microinfarcts and dementia?. Issue 5 (7th November 2017) - Hartmann, David A.
Abstract: Microinfarcts are small, but strikingly common, ischemic brain lesions in the aging human brain. There is mounting evidence that microinfarcts contribute to vascular cognitive impairment and dementia, but the origins of microinfarcts are unclear. Understanding the vascular pathologies that cause microinfarcts may yield strategies to prevent their occurrence and reduce their deleterious effects on brain function. Current thinking suggests that cortical microinfarcts arise from the occlusion of penetrating arterioles, which are responsible for delivering oxygenated blood to small volumes of tissue. Unexpectedly, pre‐clinical studies have shown that the occlusion of penetrating venules, which drain deoxygenated blood from cortex, lead to microinfarcts that appear identical to those resulting from arteriole occlusion. Here we discuss the idea that cerebral venule pathology could be an overlooked source for brain microinfarcts in humans. This article is part of the Special Issue "Vascular Dementia" . Cover Image for this Issue: doi:10.1111/jnc.14167 . Abstract : We hypothesize that obstructed penetrating venules are a source of cerebral microinfarcts – a small but widespread form of ischemic brain lesion linked to cognitive decline. In this review, we suggest that pathological mechanisms, such as cerebral hypoperfusion, arteriolosclerosis, and cerebral amyloid angiopathy, generate blood flow deficits and thrombosis in cerebral venules, leading to the formation of microinfarcts. This article is part of the Special Issue "Vascular Dementia" . Cover Image for this Issue: doi:10.1111/jnc.14167 .