All About Microvascular Ischemic Disease: Signs and Treatments

Comprehensive Guide to Microvascular Ischemic Disease

It is a brain condition common in elderly patients. If it is not treated, microvascular ischemic disease can lead to dementia and stroke and cause difficulty walking. The treatment usually consists of reducing or controlling risk factors such as high blood pressure, high cholesterol levels, high sugar levels in the blood, and smoking.

Microvascular Ischemic Disease

Microvascular ischemic disease is an overarching term that characterizes various changes in your brain's small blood vessels. The amount of these alterations can result in problems, which vary from lack of concentration to a stroke.

Microvascular ischemic disease is called:

• Cerebral small vessel disease (CSVD)
• Chronic microvascular ischemic disease
• Small vessel ischemic disease

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Causes of Microvascular Ischemic Disease

Age is the major risk factor for microvascular ischemic brain disease. In a 2019 review, the disease affected only 5% of people at the age of 50 years but almost 100% of people over 90 years.

Some other risk factors for microvascular ischemic brain disease are:

• diabetes
• high blood pressure
• high cholesterol
• inflammation of the blood vessels from infection or overactive immune system
• radiation exposure
• Smoking

It remains unidentified precisely what causes microvascular ischemic brain disease, as so many different mechanisms may have an impact on blood vessels in the brain.

For example, plaque, fatty tissue, or scar tissue can grow inside arteries, partly or completely blocking the flow of blood to the brain.

If there is not adequate blood flow, some areas of the brain tissue may not get sufficient oxygen, causing tissue death or an ischemic stroke.

Symptoms of Microvascular Ischemic Disease

Microvascular ischemic disease can thus be mild, moderate, or severe.

Many older adults — particularly those with a mild variant of the disease don't have symptoms, despite there being areas of damage in the brain. This is called "silent" disease. 

In a study conducted, up to 20 percent of healthy elderly people had silent damage in their brain, most of which came as a result of small vessel disease.

This might mean that you do not realize anything is wrong, but small changes in your thinking and physical abilities may be happening.

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More severe small vessel disease may have such symptoms as:

• loss of thinking skills, including cognitive impairment
• problems walking and with balance
• Depression

Stroke caused by small vessel disease can exhibit the following symptoms:

• sudden confusion
• vision loss in one eye or both eyes
• numbness or weakness, especially on one side of the body,
• trouble speaking or understanding
• dizziness and
• loss of balance or coordination.
• sudden, severe headache

Treatment of Microvascular Ischemic Disease

Microvascular ischemic brain disease affects the small-sized blood vessels that are less than 0.5 millimetres in diameter. Hence, this condition is challenging to find and treat with surgical interventions.

One 2015 article describes these treatment options detailed below to reduce stroke risk, cognitive decline, and physical disabilities. A doctor may prescribe one or more of the following treatment strategies based on the person's risk factors: 

• managing cholesterol levels 
• control of blood sugar if diabetes is present 
• quitting smoking
• Regular exercise and Dietary changes to help a person reach or maintain a moderate weight 
• Antihypertensive medications to prevent stroke

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Prevention of Microvascular Ischemic Disease

The following will help you safeguard the tiny blood vessels in the brain and avoid a stroke: 

• If you are obese, give control strategies and discuss with your doctor and dietitian how to achieve an appropriately healthy weight.
• Adhere to a healthy dietary pattern, like the Mediterranean Diet or DASH, which comprises nutrient-dense foods and is low in added sugar, sodium, and saturated fat.
• For an individual who smokes, choose a quit-smoking method that is best for you. You may consider counselling, nicotine replacement products, and medicines to help you lower the urge to smoke.
• Know your cholesterol, blood pressure and blood pressure levels. If they are out of range, work with the doctor to get them under control.
• Exercise for 30 minutes at the least, for a minimum of five days a week. 
• Avoid or limit alcohol.
• Based on the individual's needs, they can consult with the doctor with a more personalized approach.

Conclusion

Microvascular ischemic disease is the term used to describe changes in the small blood vessels in the brain. Damage to these vessels can cause damage to white matter—the tissue of the brain that contains the nerve fibres and serves as the connection point to the other parts of the brain.