Heghine Khachatryan: Microthrombosis and the ‘Silent Brain Injury’ Paradigm
Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared a post on LinkedIn:
”Microthrombosis and the ‘Silent Brain Injury’ Paradigm
In recent years, growing evidence has positioned microthrombosis not merely as a vascular phenomenon, but as a central driver of subclinical brain injury and progressive cognitive decline.
‘Silent microthrombosis’ represents a critical yet underrecognized mechanism linking hemostasis, inflammation, and neurodegeneration.
Key Insight
Conventional neuroimaging — particularly MRI — systematically underestimates the true burden of microvascular injury.
What remains ‘invisible’ radiologically may still exert profound biological effects.
Pathophysiologic Axis
- Endothelial dysfunction leads to microvascular occlusion
- Platelet activation and fibrin deposition
- Neuroinflammation and BBB disruption
- Progressive neuronal injury without overt stroke
Clinical Relevance
This mechanism is increasingly recognized across high-risk states:
- COVID-19–associated coagulopathy
- Cancer-associated thrombosis (Trousseau spectrum)
- Antiphospholipid syndrome (APS)
Why it matters
We may be underdiagnosing a silent epidemic of brain injury, where patients present not with stroke — but with gradual cognitive decline, fatigue, or subtle neurologic dysfunction.
This challenges us to rethink:
- The limits of imaging-based diagnostics
- The need for integrated hemostatic and neurovascular assessment
- The role of early preventive strategies targeting microthrombosis
A shift is emerging:
From visible stroke to invisible vascular injury with long-term cognitive consequences.”
Other posts featuring Heghine Khachatryan on Hemostasis Today.
-
Mar 31, 2026, 14:39Samuele Takeshita: Future Perspectives on Gene Therapy Access Through Hemophilia and Sickle Cell Disease
-
Mar 31, 2026, 14:20Dear Thamasucharit: Why Hemostasis Testing and Bleeding Disorder Awareness Matter More Than You Think
-
Mar 31, 2026, 13:49New Researchs at ACC26 on Everyday Clinical Decisions – The Lancet Group
-
Mar 31, 2026, 12:58Akshat Jain: The Invisible Struggles of Living with Von Willebrand Disease
-
Mar 31, 2026, 12:50Emmanuele Kouvousis: DOAC Dose Adjustments for Older Patients
-
Mar 31, 2026, 12:34How Clinicians Prioritize Factors in Red Blood Cell Transfusions While Following Guidelines – AABB
-
Mar 31, 2026, 12:13Tareq Abadl: What if a Hospital Bacterium Can Survive on Dry Surfaces for Days to Weeks?
-
Mar 31, 2026, 11:35Lale Tokgözoğlu: Significant CV Benefit of Lowering LDL to 44 mg/dL in Diabetes
-
Mar 31, 2026, 09:08Shamee Shastry: Sharing Perspectives on Therapeutic Apheresis at AIIMS CME