Scientists at the University of Edinburgh have found that lacunar ischemic stroke — a common, disabling stroke type — may not be primarily caused by fatty plaque in arteries as long assumed. Instead, the strongest risk factor appears to be enlargement and widening of the brain's own tiny blood vessels, a hallmark of small vessel disease. Patients with enlarged arteries were over four times more likely to have had a lacunar stroke. This finding helps explain why standard treatments like aspirin and antiplatelet drugs have had limited success. More than one in four study participants developed new silent strokes even while on standard prevention therapy. Researchers are now redirecting focus toward therapies that directly protect the brain's smallest blood vessels, including the ongoing LACI-3 clinical trial.
