СОВРЕМЕННАЯ КОНЦЕПЦИЯ ЛАКУНАРНОГО ИНФАРКТА МОЗГА И ЦЕРЕБРАЛЬНОЙ МИКРОАНГИОПАТИИ.

Lacunar infarction (LI) is a common and heterogeneous subtype of ischemic stroke, which in 3/4 cases occurs on the background of already existing subclinical manifestations of cerebral small vessel disease (SVD), which contributes to the development of recurrent LI. Dysfunction of the vascular endothelium and the blood-brain barrier (BBB) is considered to be the main pathogenetic mechanisms of the formation of LII and SVD, which develops a result of vascular risk factors action and acute or chronic ctrebtal ischemia and is manifested by impaired autoregulation of small cerebral vessels, dysfunction of the neurovascular interface in the neurovascular unit, leading to a decrease in the level of cerebral blood flow, hypoperfusion of the white matter of the brain, an increase in the permeability of the BBB. There are several potential atherosclerotic mechanisms that can lead to LI - atheromatous disease in the region of a branch of small arteries and atherosclerotic plaques of the maternal artery, which can involve the orifice of perforating branches with their occlusion, associated with g atherosclerosis of intracranial arteries. Adequate reperfusion and early antithrombotic therapy, control of risk factors for recurrent LI, the main of which is arterial hypertension, are considered a critical element of effective secondary prevention of not only lacunar stroke (LI), but also vascular dementia, vascular parkinsonism, and vascular depression. [ABSTRACT FROM AUTHOR]