What Is Chronic Ischemic Change?

Chronic microvascular ischemic change is a term that describes areas in the brain where tiny blood vessels have ruptured or clotted off, causing limited blood flow, or ischemia. It is a common finding in adults over 50 with certain chronic health conditions, such as high blood pressure, atherosclerosis or diabetes.

Brain ischemia occurs whenever blood flow to the brain is insufficient to meet metabolic demands. This results in decreased oxygen supply to brain tissue, which, in turn, causes tissue death. The medical term for this is cerebral infarction, or stroke. The term chronic cerebral ischemia describes a series of very small strokes that occur over a long time.

A stroke involving a large area of the brain typically causes severe injury and neurologic deficits, such as loss of vision, speech changes, paralysis and even death. However, in cases of chronic microvascular ischemia, the injured areas of the brain are so small and diffuse that few symptoms appear. Over time, some people with this condition experience minor deficits, such as cognitive changes, decreased memory or changes in vision. Research also indicates that long-term chronic ischemia possibly is associated with a more serious condition known as small vessel disease of the brain, a cause of age-related dementia.