Vascular endothelial function and genetic epidemiology in lacunar stroke subtypes

The lacunar stroke (15% of all strokes) is caused by blockage of a small (perforating) blood vessel in the brain. Recent research suggests that activation of the blood vessel wall initiates the syndrome. This PhD research shows raised concentrations of proteins (tissue factor pathway inhibitor and plasminogen activator inhibitor) that are excreted by the blood vessel wall, as a sign of activation of the blood vessel wall. It also turned out that first-degree relatives of patients with lacunar stroke also frequently suffered a stroke. This indicates a role of genetic factors in its origin. To further unravel the underlying mechanisms of the lacunar stroke, research should be conducted into genes that are involved in the function of the blood vessel wall. This research was supported by the Trombosestichting Nederland and the de Nederlandse Hartstichting.