Cerebral small vessel disease: pathogenesis and therapeutic challenges Cerebral small vessel disease (SVD) is a group of diseases involving small vessels in the brain and is the most common neuropathological change. Although the exact definition of SVD varies in pathologic, imaging, and clinical contexts, lacunar infarcts/lacunes, white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) are the main manifestations. The pathogenesis of SVD is heterogeneous and is not yet fully understood. Although intravenous thrombolysis and statin therapy are still used for SVD, it is known that the risk of bleeding is increased in WMH and CMBs. Dual antiplatelet therapy is detrimental to SVD, and appropriate antiplatelet drug therapy requires further study. Further research is needed on the development and prevention of SVD. REFERENCES 1 Prevention and Management of Cerebral Small Vessel Disease . Journal of Stroke 2015;17(2):111-122 2 Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges