Cerebral microinfarcts: a systematic review of neuropathological studies

J Cereb Blood Flow Metab. 2012 Mar;32(3):425-36. doi: 10.1038/jcbfm.2011.200. Epub 2012 Jan 11.


Vascular cognitive impairment is an umbrella term for cognitive dysfunction associated with and presumed to be caused by vascular brain damage. Autopsy studies have identified microinfarcts as an important neuropathological correlate of vascular cognitive impairment that escapes detection by conventional magnetic resonance imaging (MRI). As a frame of reference for future high-resolution MRI studies, we systematically reviewed the literature on neuropathological studies on cerebral microinfarcts in the context of vascular disease, vascular risk factors, cognitive decline and dementia. We identified 32 original patient studies involving 10,515 people. The overall picture is that microinfarcts are common, particularly in patients with vascular dementia (weighted average 62%), Alzheimer's disease (43%), and demented patients with both Alzheimer-type and cerebrovascular pathology (33%) compared with nondemented older individuals (24%). In many patients, multiple microinfarcts were detected. Microinfarcts are described as minute foci with neuronal loss, gliosis, pallor, or more cystic lesions. They are found in all brain regions, possibly more so in the cerebral cortex, particularly in watershed areas. Reported sizes vary from 50 μm to a few mm, which is within the detection limit of current high-resolution MRI. Detection of these lesions in vivo would have a high potential for future pathophysiological studies in vascular cognitive impairment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Biomedical Research
  • Brain* / blood supply
  • Brain* / pathology
  • Cerebral Infarction / complications
  • Cerebral Infarction / pathology*
  • Cerebral Infarction / physiopathology
  • Cerebral Infarction / psychology*
  • Cerebrovascular Circulation / physiology
  • Cognition / physiology
  • Cognition Disorders / etiology
  • Cognition Disorders / pathology
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology
  • Dementia, Vascular / etiology
  • Dementia, Vascular / pathology
  • Dementia, Vascular / physiopathology
  • Dementia, Vascular / psychology
  • Humans
  • Magnetic Resonance Imaging
  • Neuropsychological Tests
  • Severity of Illness Index