# Cerebral small vessel disease (CSVD)

Cerebral small vessel disease (CSVD) is damage to your brain's tiniest blood vessels: the small arteries, arterioles, capillaries, and venules. It shows up on brain scans as a recognizable set of changes: white-matter hyperintensities, small deep strokes (lacunar infarcts), enlarged fluid spaces around vessels, microbleeds, and surface iron staining. High blood pressure is the biggest fixable risk factor. Others include diabetes, abnormal cholesterol, smoking, and certain genes (like NOTCH3 mutations in a condition called CADASIL). CSVD causes about 20% of all strokes (around 25% of the clot-type ones, mostly lacunar) and is the leading cause of vascular cognitive impairment. As the damage adds up, it tracks with trouble planning and focusing, unsteady walking, depression, and a slide toward vascular dementia. There is no drug yet that targets CSVD directly. Controlling blood pressure is the best-proven way to slow it down.

## Sources

- Hainsworth AH, Markus HS, Schneider JA. (2024). Cerebral small vessel disease, hypertension, and vascular contributions to cognitive impairment and dementia. Hypertension. https://doi.org/10.1161/HYPERTENSIONAHA.123.19943
- Liu X, Sun P, Yang J, Fan Y. (2022). Biomarkers involved in the pathogenesis of cerebral small-vessel disease. Frontiers in Neurology. https://doi.org/10.3389/fneur.2022.969185

---

_Canonical: https://longevity-switzerland.com/en/glossary/cerebral-small-vessel-disease · Part of Longevity Cities · Updated 2026-06-22_