[Cerebral microangiopathies]

Abstract

Cerebral small vessels disease are characterized by lesions of the wall of the small cerebral arteries. They are responsible for 25 to 30% of strokes due to cerebral infarction or hemorrhage and/or cognitive impairment, dementia. Lipohyalinosis and cerebral amyloid angiopathy are the most common etiologies. They are associated with age, arterial hypertension, and diabetes. The localization of the lesions by MRI could help to differentiate both etiologies: deep localisation for lipohyalinosis and lobar (cortical) for cerebral amyloid angiopathy. Physiopathology of these diseases is not presently understood, and no specific treatment is available. Therefore, treatment of vascular risk factors (diabetes, arterial hypertension) is the only therapeutic measure available.