Brain Microcirculation and Silent Cerebral Damage

  • Cristina SierraEmail author
  • Antonio Coca


Besides age, hypertension is the cardiovascular risk factor most closely related to cerebrovascular disease. Hypertension seems to predispose to the development of cognitive impairment, dementia, and ischemic and hemorrhagic stroke after a period of time that may vary from a few years to several decades. During this time, during which the majority of hypertensives remain asymptomatic, elevated blood pressure predisposes to the development of subtle alterations, based on arteriolar narrowing or microvascular changes that involve chronic ischemia of the small arteries (cerebral white matter lesions, lacunar infarcts), as well as deposits of hemosiderin in perivascular spaces (cerebral microbleeds), mainly in deep perforating arteries in the brain. Despite the strong epidemiological relationship, the etiopathogenic mechanisms through which hypertension leads to cerebral pathology are diverse, complex and not completely understood.


Hypertension Cerebral small vessel disease Cerebral white matter lesions Cerebral microbleeds Lacunar infarcts Stroke Cognitive impairment 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, IDIBAPSUniversity of BarcelonaBarcelonaSpain

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