Scientists have found a new reason why a common type of stroke happens. They discovered that the tiny blood vessels inside the brain get bigger and stretch, and this change is linked to the stroke.
What Is a Lacunar Stroke?
A lacunar stroke happens when the smallest blood vessels in the brain are damaged. It can cause trouble moving, thinking, and can lead to dementia. Doctors have struggled to know why these tiny vessels get hurt.
What the Study Looked At
Researchers studied 229 people who had a recent stroke. Some had a lacunar stroke, and others had a different kind. Everyone got health checks, memory tests, and brain scans right after the stroke and again one year later.
Two Types of Blood‑Vessel Changes
The team compared two things:
- Fatty buildup that narrows big arteries.
- Enlargement and stretching of the tiny brain arteries.
Enlarged Arteries Matter Most
The scans showed that the fatty narrowing did not predict a lacunar stroke. In contrast, people whose brain arteries were wider were over four times more likely to have had a lacunar stroke.
Wider arteries also meant more severe small‑vessel disease, faster brain damage, and a higher chance of “silent” strokes—tiny areas of injury that cause no obvious symptoms.
Why Current Medicines May Miss the Mark
Common drugs like aspirin work by stopping blood clots in big arteries. Since lacunar strokes are tied to tiny‑vessel damage, these medicines often do not stop them well.
New Treatments on the Horizon
Trials such as LACI‑3 are testing medicines that protect the brain’s smallest vessels. Drugs like cilostazol and isosorbide mononitrate are being studied to see if they can lower repeat strokes and improve memory and movement after a lacunar stroke.
What This Means for Patients
The study tells doctors that looking after the tiny blood vessels in the brain is crucial. Future care may focus more on protecting those vessels rather than only clearing fatty plaque from larger arteries.
Understanding this difference helps explain why some stroke‑prevention pills work poorly for lacunar strokes and points the way toward better treatments.