Small vessel disease — radiological feature and clinical implications

Cerebral small vessel disease (SVD) is commonly observed on neuroimaging among elderly individuals and is recognized as a risk factor for stroke, cognitive decline, gait impairment, and mood disturbance. Clinical features often vary in severity and presentation even among patients with similar SVD findings on brain imaging. The Standards for Reporting Vascular Changes on Neuroimaging (STRIVE) initiative (STRIVE 1 and 2) established standardized terminology for the radiological features of SVD and clarified their interrelationships. This article presents current knowledge about the effects of SVD on structural and functional brain connectivity, as well as the radiological and clinical implications of SVD, with particular attention to cognitive and behavioral disturbances.