Small vascular infarcts in the brain, caused by factors like high blood pressure, high cholesterol, smoking, diabetes, or aging, can become symptomatic if they coalesce or affect critical thinking areas.

“so we all get with aging some amount of tiny little strokes and i know that sounds scary but as we get older you know for various reasons high blood pressure high cholesterol smoking diabetes and even just normal aging there can be blocking of blood vessels changes in circulation that cause us to have these tiny little infarcts these are not anything you would notice you would never have symptoms you wouldn't go to the hospital but there can be an accumulation of them and there's a certain amount that's sort of normal when it's extremely mild or scattered but then when they start to you know coalesce or they start to extend into cortical areas parts of the brain that sort of matter more in terms of critical thinking then they can be symptomatic”