Pathology
Long standing poorly controlled hypertension leads to a variety of pathological changes in the vessels.
microaneurysms of perforating arteries (Charcot-Bouchard aneurysms)
small (0.3-0.9 mm) diameter aneurysms that occur on small (0.1-0.3 mm) diameter arteries
a distribution that matches incidence of hypertensive haemorrhages 5
80% lenticulostriate
10% pons
10% cerebellum
found in hypertensive patients
may thrombose, leak (see cerebral microhaemorrhages) or rupture 2
accelerated atherosclerosis: affects larger vessels
hyaline arteriosclerosis
hyperplastic arteriosclerosis: seen in very elevated and protracted cases