The role of hypertension in pathogenesis of stroke has been well documented in other studies, which include the initiation of vasculopathy, promotion of microatheroma, lipohyalinosis
, and atherosclerotic diseases, and blood-brain barrier disruption .
In haemorrhagic stroke, atherosclerosis role is limited; main cause for haemorrhagic stroke is hypertension, lipohyalinosis
, cerebral amyloid angiopathy and fibrinoid necrosis.
Lacunar infarct occurs due to occlusion caused by a microthrombus or lipohyalinosis
in a penetrating artery in the basal ganglia, thalamus, and pons.
The presence of other infarction areas in the PCA territory (supplying the occipital and the mesial temporal lobe) or their branches (e.g., collicular artery, posteromedial choroidal artery, penetrating midbrain arteries, etc.) could help to consider other mechanisms of stroke than lipohyalinosis
However, many white-matter lacunar strokes are considered to be a consequence of small vessel lipohyalinosis
We therefore concluded that plasma Lp(a) is associated with atherothrombotic cardiovascular disease phenotypes and appears to show no association with nonatherosclerotic pathologies such as SAO, which is typically associated with lipohyalinosis
. Because a large proportion (86%) of ME cases had LAA as one of their associated pathologies, we considered it reasonable to combine these ME cases with LAA cases in the LAA group to further increase the power of the study.
Hypertension increases the likelihood of stroke in several ways: by aggravating atherosclerosis in the aortic arch and cervicocerebral arteries; by causing arteriosclerosis and lipohyalinosis
in the small-diameter, penetrating-end arteries of the cerebrum; and by contributing to heart disease.
Intimal fibroplasia, lipohyalinosis
, and fibrinoid necrosis were absent.
Previous studies have also demonstrated a low prevalence of carotid stenosis in lacunar infarction, suggesting that lacunar infarcts are due to small vessel disease (micro-atheroma or lipohyalinosis
) and not large vessel atheroma [22-27].
Lacunar infarctions are almost always caused by microvascular disease (either microatheroma or lipohyalinosis
of small penetrating vessels), less commonly by plaques in large arteries that encroach on the orifice of a small vessel.
The SVD subtype, also called lacuna stroke, usually occurs due to the fibrinoid necrosis and lipohyalinosis
of arterioles affected by hypertension-induced pathological processes.
On pathological examination, WMLA are areas of demyelination, gliosis, perivascular oedema, and lipohyalinosis
of the deep penetrating arteries [8, 9].