The burden of cerebrovascular disease is high: each year, approximately 795 000 people in the United States experience a new or recurrent stroke, leading to death in 128 824 individuals or being associated with death in 215 864 cases.1 However, the number of silent infarcts and microhemorrhages is much higher, causing cognitive and behavioral impairment in 17% of the population older than 65 years.2 These usually primarily asymptomatic events are often caused by cerebral small vessel disease (SVD) detected as white matter hyperintensities, lacunas, microbleeds, and cortical and subcortical atrophy in magnetic resonance imaging (MRI) of elderly people. These MRI changes have a high prevalence in this population.3 The long-term prognosis of SVD is highly variable, but functional decline and death may be a consequence.4,5