Blood vessels traveling from the heart branch into smaller vessels inside the brain, delivering oxygen and nutrients. These small vessels can become abnormal with age, or conditions like diabetes and high blood pressure. People with small vessel disease have damage to the cables the brain cells use to communicate -- and to certain deep clusters of brain cells. The damage develops due to blockage of blood flow or bleeding from small blood vessels in the brain. While some people with small vessel brain disease have no symptoms, others develop problems with thinking, mood and movement.
Small vessel brain disease can lead to thinking problems. When severe, this is called vascular dementia. Although estimates vary, a June 2014 "BioMed Research International" article reports that blood vessel problems account for 20 percent of dementia worldwide -- second only to Alzheimer disease. Small vessel brain disease typically causes milder memory problems than Alzheimer disease, mainly with recalling information. There can also be difficulties with staying focused, problem-solving and planning tasks. Overall slowing of thinking and responding can occur.
Mood and Personality Changes
Mood and personality changes may signal small vessel brain disease. Depression can occur alone or along with thinking problems and can worsen over time. In contrast to Alzheimer disease, people with vascular dementia can have mood swings or personality changes early in the course of disease. They may become irritable or impatient or stop caring about themselves or their surroundings. People with small vessel disease may also develop uncontrollable and possibly inappropriate episodes of laughter or crying.
Movement Problems and Other Symptoms
Small vessel brain disease commonly causes strokes, in which an area of the brain is deprived of oxygen and dies. Some strokes cause no obvious symptoms despite the brain damage. Other strokes cause sudden weakness or numbness on one side of the body, problems with coordination, difficulty speaking or swallowing, or double vision. People with small vessel brain disease typically accumulate tiny strokes over time, leading to problems with balance and slow walking due to trouble managing the sequence of walking. They are at risk of falling earlier than people with Alzheimer disease. They may also have urinary accidents due to a sudden urge to go.
When to Seek Medical Attention
Work with your doctor to control conditions that increase your risk for small vessel brain disease, such as diabetes and high blood pressure. Be sure to talk with your doctor if you notice changes in your memory, mood, balance or walking. Seek emergency medical attention if you experience sudden changes in your strength, sensation, speech, vision or coordination.
- UC Memory Disorders Center: Vascular Cognitive Impairment
- BioMed Research International: Global Epidemiology of Dementia: Alzheimer’s and Vascular Types
- Stroke Research and Treatment: Small Vessel Cerebrovascular Disease: The Past, Present, and Future
- Cerebrovascular Diseases: 2001–2011: A Decade of the LADIS (Leukoaraiosis and DISability) Study: What Have We Learned About White Matter Changes and Small-Vessel Disease?
- Nature Clinical Practice Neurology: Vascular Cognitive Impairment
- International Journal of Medical Sciences: Microbleeds and Silent Brain Infarctions Are Differently Associated With Cognitive Dysfunction in Patients With Advanced Periventricular Leukoaraiosis
- Neurology: Depression in Small-Vessel Disease Relates to White Matter Ultrastructural Damage, Not Disability
- Stroke: Cerebral White Matter Lesions and Lacunar Infarcts Contribute to the Presence of Mild Parkinsonian Signs
- Journal of Aging Research: Age-Related White Matter Changes