Microvascular ischemic disease describes conditions that affect the small blood vessels in the brain. These conditions include stroke, cerebral hemorrhage, and dementia.

Age, high blood pressure, and diabetes are among the primary risk factors for microvascular ischemic brain disease.

Microvascular ischemic disease can also occur in other organs, including the heart, kidney, or eyes.

In this article, we provide more information on microvascular ischemic brain disease, including its symptoms, causes, and treatment.

Doctors use the term microvascular ischemic disease to refer to changes that occur in the walls of the small blood vessels of an organ.

Conditions that affect these blood vessels can damage white matter in the brain. White matter contains nerve fibers that send signals between different parts of the brain.

Microvascular ischemic brain disease is a “silent” disease, which means that most people who have it do not experience noticeable symptoms.

However, doctors can look for signs of microvascular ischemic disease using brain MRI scans.

Microvascular ischemic disease commonly affects older adults. Without treatment, it can significantly contribute to cognitive decline, dementia, stroke, and walking problems.

The symptoms of microvascular ischemic brain disease can range from mild to severe, depending on the extent of the damage.

People who have mild forms of microvascular ischemic brain disease may have no symptoms. However, those with more advanced white matter damage may experience:

  • difficulty thinking
  • problems focusing
  • memory loss
  • changes in mood
  • depression
  • difficulty sleeping
  • changes in bladder habits

Small vessel disease accounts for up to 25% of all ischemic strokes. The symptoms of a stroke include:

  • weakness in one side of the body
  • slurred speech
  • incoordination
  • dizziness
  • numbness in the face, arms, or legs
  • vision problems
  • confusion

Anyone experiencing symptoms of a stroke requires immediate medical attention.

Age is a significant risk factor for microvascular ischemic brain disease. According to a 2019 review, the disease affects just 5% of people aged 50 years but nearly 100% of people over the age of 90 years.

Other risk factors for microvascular ischemic brain disease include:

The exact cause of microvascular ischemic brain disease is not yet well-understood, however, as many factors can affect the blood vessels in the brain.

For instance, the accumulation of plaque, fatty tissue, or scar tissue inside arteries can partially or entirely restrict blood flow to the brain.

Without enough blood flow, certain areas of brain tissue may not receive enough oxygen, which can result in tissue damage or an ischemic stroke.

Microvascular ischemic brain disease affects tiny blood vessels that are less than 0.5 millimeters (mm) in diameter, which makes the condition challenging to identify and treat with surgical procedures.

According to a 2015 article, treatment options include lifestyle changes and medications to help reduce the risk of stroke, cognitive decline, and physical disabilities.

A doctor may recommend one or more of the following treatment strategies, depending on a person’s risk factors:

  • control of blood sugar, if diabetes is present
  • managing cholesterol levels
  • dietary changes and regular exercise to help a person reach or maintain a moderate weight
  • quitting smoking
  • blood pressure medications, such as losartan (Cozaar) or lisinopril (Prinivil)
  • antiplatelet drugs, such as cilostazol (Pletal), to help prevent stroke

There are currently no specific recommendations on how to prevent microvascular ischemic brain disease.

However, people can lower their risk of developing microvascular ischemic brain disease by improving their cardiovascular health.

Steps to improve cardiovascular health include:

Microvascular ischemic brain disease does not always cause symptoms, but it can contribute to other medical conditions, such as stroke and dementia.

The risk of developing microvascular ischemic diseases increases with age. People can speak with their doctor about reducing their risk by exercising regularly, making dietary changes, and taking medications that help control cholesterol levels and blood pressure.