Degenerative small vessel wall changes, small bleeds and infarcts in SHRSP. Degenerative small vessel wall changes include arteriolosclerosis (A &B, hippocampus), lipohyalinosis (C, basal ganglia) and thickening of the extracellular matrix (D, hippocampus &E, basal ganglia) with associated enlarged perivascular spaces (A – C). Erythrocytes, leaking through injured small vessel walls, form perivascular bleeds (F &G, cortex). Reactive small vessel occlusions (white asterisks) surrounded by perivascular mini- and microbleeds (H &I, cortex) with consecutive infarcts consisting of spongy, cystic and hemorrhagic tissue (I) are the consequence and represent the final stage of cerebral small vessel disease in SHRSP. A &B – Congo red staining, C, F - I - HE staining, D &E – Movat staining.