ArticleEuropean stroke journal2021
ESO Guideline on covert cerebral small vessel disease.
Article in European stroke journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 87 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
87 citing papers in PubMed, 4 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Implications of Cranial Arterial Stenosis and Dolichoectasia for Cerebral Small-Vessel Disease Etiopathogenesis: Findings From a Prospective Mild Stroke Cohort.Circulation · 2026Pooled it
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- Associations of Cerebrovascular Regulation and Arterial Stiffness With Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2023Pooled it
- Leukoaraiosis Distribution and Cerebral Collaterals: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2022Pooled it
- Intensive Blood Pressure Treatment and Subclinical Brain Infarcts: A Secondary Analysis of SPRINT (Systolic Pressure Intervention Trial).Annals of neurology · 2024Trial
- Antiplatelet Therapy for Stroke Prevention in Atherosclerotic Cardiovascular Disease-Naïve People with Cerebral Small-Vessel Disease: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Experimental models of cerebral small vessel disease: Physiological constraints, translational challenges and future directions.The Journal of physiology · 2026Review
- Clinically reported covert cerebrovascular disease and risk of neurological disease: a whole-population cohort of 367 988 people using natural language processing.Journal of neurology, neurosurgery, and psychiatry · 2026Article
- Retinal hemodynamic and caliber biomarkers for the assessment of cerebral small vessel disease burden: insights from fundus fluorescein angiography.BMC neurology · 2026Article
- Dynamic Changes in Endothelial Glycocalyx and Inflammatory Response in Patients with Acute Ischemic Stroke Treated with Mechanical Thrombectomy: Pathophysiological Aspects and Clinical Implications.Neurology international · 2026Review
- Repurposing drugs for the prevention of vascular dementia using evidence from drug target Mendelian randomization.Nature aging · 2026Article
- Cerebral Small Vessel Disease and Blood-Brain Barrier Disruption: Mechanisms and Therapeutic Strategies in Cognitive Impairment.Translational stroke research · 2026Review
- Identification of distinct and shared biomarker panels in different manifestations of cerebral small-vessel disease through proteomic profiling.Nature aging · 2026Article
- Endothelial TRIM47 regulates blood-brain barrier integrity and cognition via the KEAP1/NRF2 signalling pathway in mice.Communications biology · 2026Article
- Causal Effect of Dietary Patterns on Cerebral Small Vessel Disease: A Mendelian Randomization Study.Food science & nutrition · 2026Article
- Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Transcranial doppler detected right-to-left shunt is common but not associated with MRI white matter hyperintensity burden: a cross-sectional study.European stroke journal · 2026Article
- Age-inappropriate white matter injury reveals hidden cerebral small vessel disease burden and mortality risk.Cerebral circulation - cognition and behavior · 2026Article
- Defining patient-reported outcomes and priorities for clinical trials in CADASIL through an international survey.Cerebral circulation - cognition and behavior · 2026Article
- Cardiovascular risk factor control in patients with covert brain infarcts in the prospective SILENT cohort study.European stroke journal · 2026Observational
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 12 institutions in 9 countries.
Funding
Abstract
'Covert' cerebral small vessel disease (ccSVD) is common on neuroimaging in persons without overt neurological manifestations, and increases the risk of future stroke, cognitive impairment, dependency, and death. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist with clinical decisions about management of ccSVD, specifically white matter hyperintensities and lacunes, to prevent adverse clinical outcomes. The guidelines were developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We prioritised the clinical outcomes of stroke, cognitive decline or dementia, dependency, death, mobility and mood disorders, and interventions of blood pressure lowering, antiplatelet drugs, lipid lowering, lifestyle modifications, glucose lowering and conventional treatments for dementia. We systematically reviewed the literature, assessed the evidence, formulated evidence-based recommendations where feasible, and expert consensus statements. We found little direct evidence, mostly of low quality. We recommend patients with ccSVD and hypertension to have their blood pressure well controlled; lower blood pressure targets may reduce ccSVD progression. We do not recommend antiplatelet drugs such as aspirin in ccSVD. We found little evidence on lipid lowering in ccSVD. Smoking cessation is a health priority. We recommend regular exercise which may benefit cognition, and a healthy diet, good sleep habits, avoiding obesity and stress for general health reasons. In ccSVD, we found no evidence for glucose control in the absence of diabetes or for conventional Alzheimer dementia treatments. Randomised controlled trials with clinical endpoints are a priority for ccSVD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.