Chronic Cerebral Ischemia: From Pathogenesis to Therapy (Recommendations for an Outpatient Neurologist)

The prevalence of cerebrovascular disease is increasing, significantly affecting patients' quality of life and often leading to disability. Disorders of small-caliber cerebral vessels contribute to nearly 40% of dementia cases worldwide and account for one in every five strokes occurring each year. Cerebral microangiopathy can also cause structural damage to the brain, including white matter lesions, lacunar infarcts, microbleeds, and secondary cerebral atrophy. These changes may remain unnoticed for years but greatly increase the risk of dementia and disabling strokes.

Arterial hypertension is the most common cause of cerebral microangiopathy, leading to arteriosclerosis in small penetrating arteries and arterioles. Endothelial dysfunction plays a crucial role in initiating and sustaining vascular damage. Research shows that individuals with cerebral microangiopathy have elevated markers of endothelial injury in their blood. Early and effective therapy is essential in reversing endothelial dysfunction and preventing cerebrovascular disease.

Divaza, a pleiotropic drug, has been scientifically proven to be an effective adjuvant therapy for managing anxiety and depressive symptoms associated with cerebral microangiopathy.