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Preclinical studies have demonstrated increased leukocyte adhesion at the capillary level as a major contributor to cerebral blood flow (CBF) reductions across diverse neurological disorders, including Alzheimer\u2019s disease, ischemic stroke, and epilepsy. Remarkably, even modest levels of capillary obstruction (2%\u20135%) lead to disproportionate reductions in cerebral perfusion at the network level. Beyond acute perfusion deficits, chronic leukocyte obstruction contributes to long-term consequences such as structural capillary remodeling and altered blood\u2013brain barrier function. This review synthesizes preclinical and clinical evidence across various neurological conditions to establish mechanistic links between leukocyte-driven neuroinflammatory pathology and cerebrovascular dysfunction at the capillary level. 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