Researchers at the University of Edinburgh have found evidence suggesting that a common form of stroke has a different cause than previously believed. It appears that so-called lacunar ischemic stroke is not primarily caused by fatty deposits in the arteries, but rather by pathological changes in the small blood vessels deep within the brain.
The study examined 229 individuals who had experienced either a lacunar stroke or another type of minor stroke. MRI scans taken shortly after the event and one year later showed that it was not the narrowing of large arteries, but rather the widening and lengthening of cerebral arteries, that was strongly associated with lacunar stroke. Patients with dilated arteries were more than four times more likely to experience this type of stroke. Furthermore, these vascular changes were linked to a more rapid progression of brain damage and so-called silent strokes – small tissue lesions without noticeable symptoms.
These findings may explain why common preventive medications like aspirin often have limited effectiveness in this type of stroke. They target blood clots, not the underlying damage to the small vessels. Lead researcher Joanna Wardlaw emphasizes the need for new therapies that specifically protect microvessels. An ongoing study (LACI-3) is investigating relevant active compounds.
Source: University of Edinburgh / UK Dementia Research Institute, published in the journal "Circulation", July 2026.
