Pathology of small vessel stroke

Disease of small intracerebral vessels is widely assumed to be responsible for the majority of small, deep-seated (lacunar) infarcts and primary intracerebral haemorrhages. Our present, limited understanding of the pathogenesis of these stroke subtypes, which together constitute up to one-third of all strokes, is based on a limited number of detailed pathology studies, supported by clinical, risk factor and imaging data. Further progress using these traditional approaches has been prevented by a variety of largely technical obstacles. It is suggested that advances in our understanding of the genetic basis of established and new animal stroke models, in turn linked to more focused human genetic stroke surveys, may hold the key to further insights.