Understanding the differences with strokes in CADASIL

Small Vessel Disease/Lacunar Infarction
Small vessel disease, or lacunar infarction, occurs when blood flow is blocked to a very small arterial vessel. The term's origin is from the Latin word lacuna which means hole.

Patients with CADASIL - if they have strokes, they have the small vessel type of  stroke (only 20% of overall strokes are due to small vessel occlusion and CADASIL  type of stroke falls into this category)  - a small artery closes on its own, not necessarily due to a clot.


Transient Ischemic Attacks (TIA) (sometimes called a mini-stroke)
Starts just like a stroke but then resolves leaving no noticeable symptoms or deficits. The addition of other risk factors compounds a person's risk for a recurrent stroke. The average duration of a TIA is a few minutes. For almost all TIAs, the symptoms go away within an hour. There is no way to tell whether symptoms will be just a TIA or persist and lead to death or disability. The patient should assume that all stroke symptoms signal an emergency and should not wait to see if they go away.

NOTE: It does not mean patients with CADASIL can not have also large vessel disease - carotid artery plaque or cardioembolic type of stroke - when a blood clot forms in carotid artery plaque or the heart, goes to the brain and plugs a vessel deeper in the brain.

Even though a stroke occurs in the unseen reaches of the brain, the symptoms of a stroke are easy to spot. They include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. All of the symptoms of stroke appear suddenly, and often there is more than one symptom at the same time. Therefore strokes can usually be distinguished from other causes of dizziness or headache. These symptoms may indicate that a stroke has occurred and that medical attention is needed immediately.