When doctors try to prevent a stroke, the focus is often on keeping major arteries clear and reducing the risk of blood clots. But a new study suggests that approach may not address the underlying cause of one of the world's most common stroke types.
Reporting in Circulation, researchers led by the University of Edinburgh found evidence that lacunar stroke is more closely linked to damage affecting the brain's smallest blood vessels than to fatty narrowing of larger arteries.
The findings could help explain why current preventive treatments do not always work as expected, reports Science Daily.
Looking beyond blocked arteries
To investigate, scientists monitored 229 people who had experienced a mild stroke, using brain scans and clinical assessments over the course of a year.
Also read: What happens to the body after stopping GLP 1 weight loss drugs
Rather than finding a connection between blocked larger arteries and lacunar stroke, the team found that patients with enlarged arteries inside the brain were far more likely to have this specific type of stroke.
Those vascular changes were also associated with worsening small vessel disease and additional brain injury over time.
More than 25% of participants developed new "silent" strokes during follow-up, despite receiving standard preventive medication.
A new direction
The findings suggest that future treatments may need to focus on preserving the health of the brain's microscopic blood vessels instead of targeting plaque in larger arteries alone.
Also read: Researchers test new breast cancer treatment - without surgery
Researchers are already exploring that possibility through the ongoing LACunar Intervention Trial 3 (LACI-3), which is evaluating whether existing medicines can reduce further brain damage and lower the risk of complications such as memory decline, dementia and additional strokes.
While more research is needed before treatment guidelines change, the study offers a different way of understanding a condition that affects thousands of people each year and may help shape future strategies for stroke prevention.
Also read: Four weeks of dietary changes affected biological age markers, study finds