Cerebrovascular disease

"Cerebrovascular diseases" redirects here. For the medical journal, see Cerebrovascular Diseases (journal).
Cerebrovascular disease
Cerebral angiogram of a carotid-cavernous fistula
SpecialtyNeurology
SymptomsWeakness on one side of body[1]
TypesStroke, vascular dementia, TIA, subarachnoid haemorrhage[2]
Diagnostic methodNeurological exam, physical exam[3]
TreatmentBlood thinners, anti-hypertensives[4]

Cerebrovascular disease includes a variety of medical conditions that affect the blood vessels of the brain and the cerebral circulation. Arteries supplying oxygen and nutrients to the brain are often damaged or deformed in these disorders.[2] The most common presentation of cerebrovascular disease is an ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke.[2] Hypertension (high blood pressure) is the most important contributing risk factor for stroke and cerebrovascular diseases as it can change the structure of blood vessels and result in atherosclerosis.[5] Atherosclerosis narrows blood vessels in the brain, resulting in decreased cerebral perfusion. Other risk factors that contribute to stroke include smoking and diabetes.[6] Narrowed cerebral arteries can lead to ischemic stroke, but continually elevated blood pressure can also cause tearing of vessels, leading to a hemorrhagic stroke.[4]

A stroke usually presents with an abrupt onset of a neurologic deficit – such as hemiplegia (one-sided weakness), numbness, aphasia (language impairment), or ataxia (loss of coordination) – attributable to a focal vascular lesion.[7] The neurologic symptoms manifest within seconds because neurons need a continual supply of nutrients, including glucose and oxygen, that are provided by the blood. Therefore, if blood supply to the brain is impeded, injury and energy failure is rapid.[8]

Besides hypertension, there are also many less common causes of cerebrovascular disease, including those that are congenital or idiopathic and include CADASIL, aneurysms, amyloid angiopathy, arteriovenous malformations, fistulas, and arterial dissections.[9] Many of these diseases can be asymptomatic until an acute event, such as a stroke, occurs.[9] Cerebrovascular diseases can also present less commonly with headache or seizures.[10] Any of these diseases can result in vascular dementia due to ischemic damage to the brain.[11][12]

  1. ^ Cite error: The named reference weak was invoked but never defined (see the help page).
  2. ^ a b c Cite error: The named reference NHS2015 was invoked but never defined (see the help page).
  3. ^ Cite error: The named reference str was invoked but never defined (see the help page).
  4. ^ a b Cite error: The named reference Med2015 was invoked but never defined (see the help page).
  5. ^ "Who Is at Risk for a Stroke?". NHLBI, NIH. Archived from the original on Oct 5, 2017. Retrieved 2017-11-25.
  6. ^ Prakash, Dibya (2014-04-10). Nuclear Medicine: A Guide for Healthcare Professionals and Patients. Springer Science & Business Media. p. 142. ISBN 9788132218265.
  7. ^ "AccessMedicine | Content". accessmedicine.mhmedical.com. Retrieved 2015-11-05.
  8. ^ "AccessMedicine | Content". accessmedicine.mhmedical.com. Archived from the original on 2016-03-04. Retrieved 2015-11-05.
  9. ^ a b Sabiston textbook of surgery : the biological basis of modern surgical practice. Townsend, Courtney M., Jr.; Beauchamp, R. Daniel; Evers, B. Mark; Mattox, Kenneth L. (20th ed.). Philadelphia, PA: Elsevier. 2017. pp. 1900–1937. ISBN 978-0323299879. OCLC 951748294.{{cite book}}: CS1 maint: others (link)
  10. ^ Salmela, Michael B; Mortazavi, Shabnam; Jagadeesan, Bharathi D; Broderick, Daniel F; Burns, Judah; Deshmukh, Tejaswini K; Harvey, H. Benjamin; Hoang, Jenny; Hunt, Christopher H; Kennedy, Tabassum A; Khalessi, Alexander A; Mack, William; Patel, Nandini D; Perlmutter, Joel S; Policeni, Bruno; Schroeder, Jason W; Setzen, Gavin; Whitehead, Matthew T; Cornelius, Rebecca S; Corey, Amanda S; Corey, A. S (2017). "ACR Appropriateness Criteria ® Cerebrovascular Disease". Journal of the American College of Radiology. 14 (5): S34–S61. doi:10.1016/j.jacr.2017.01.051. PMID 28473091.
  11. ^ Kuźma, Elżbieta; Lourida, Ilianna; Moore, Sarah F.; Levine, Deborah A.; Ukoumunne, Obioha C.; Llewellyn, David J. (2018). "Stroke and dementia risk: A systematic review and meta-analysis". Alzheimer's & Dementia. 14 (11): 1416–1426. doi:10.1016/j.jalz.2018.06.3061. hdl:2027.42/152961. ISSN 1552-5260. PMC 6231970. PMID 30177276. Archived from the original on 2021-08-28. Retrieved 2018-09-07.
  12. ^ "Vascular dementia - Causes - NHS Choices". www.nhs.uk. Archived from the original on 2017-08-22. Retrieved 2015-09-01.