A 68-year-old obese woman (BMI =34 kg/m2) suffers a stroke and expires. Histologic examination of the brainat autopsy reveals extensive arteriolar lipohyalinosis and numerous Charcot-Bouchard aneurysms. Which of the following best accounts for the pathogenesis of these autopsy findings?

Hypertension compromises the integrity of cerebral arterioles by causing the deposition of lipid in, and hyalinization of, the arterial walls, an alteration referred to as lipohyalinosis. Further weakening of the wall leads to the formation of Charcot-Bouchard aneurysms, which are located mainly along the trunk of a vessel rather than at its bifurcation. Although the other choices affect blood vessels, they do not typically cause cerebral microaneurysms.Diagnosis: Hypertensive stroke, cerebral hemorrhage