Cerebrovascular Disease
Conditions affecting the blood vessels that supply the brain
Quick Facts
- Type: Disorders of the brain's blood vessels
- Main risk: Stroke and reduced blood flow to the brain
- Common causes: Atherosclerosis, high blood pressure
- Largely preventable: Through managing risk factors
Overview
Cerebrovascular disease is a general term for conditions that affect the blood vessels supplying the brain. The brain needs a constant flow of oxygen-rich blood to work, and when these vessels become narrowed, blocked, or damaged, parts of the brain can be injured. The most serious result is a stroke.
Cerebrovascular disease includes a range of problems, such as narrowing of the arteries that feed the brain, weakened or bulging vessel walls (aneurysms), and bleeding within or around the brain. Many of these conditions develop slowly over years and share the same risk factors as heart disease.
The encouraging news is that much cerebrovascular disease is preventable. Because it shares risk factors with heart disease, the same healthy habits and treatments that protect the heart also protect the brain. Recognizing the warning signs of a stroke and acting quickly can also greatly reduce the lasting damage when an event does occur.
Symptoms
Cerebrovascular disease may cause no symptoms until blood flow to the brain is seriously reduced. When symptoms occur, they often appear suddenly and signal a stroke or a warning stroke (transient ischemic attack):
- Sudden numbness or weakness of the face, arm, or leg, usually on one side
- Sudden confusion or trouble speaking or understanding speech
- Sudden trouble seeing in one or both eyes
- Sudden severe headache with no known cause
- Sudden dizziness, loss of balance, or trouble walking
These are emergencies. A useful reminder is FAST: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services.
Causes
Most cerebrovascular disease is caused by damage and narrowing of the blood vessels over time. Key causes include:
- Atherosclerosis: A buildup of fatty deposits that narrows and hardens the arteries supplying the brain.
- High blood pressure: Long-term high pressure damages vessel walls and is a leading cause of both blocked and bleeding strokes.
- Blood clots: Clots can form in the brain's vessels or travel there from the heart, blocking blood flow.
- Weakened vessels: Aneurysms and other vessel abnormalities can bleed.
Diabetes, smoking, and abnormal cholesterol all speed up this damage.
Risk Factors
- High blood pressure
- Smoking
- Diabetes
- High cholesterol
- Obesity and physical inactivity
- Atrial fibrillation (an irregular heartbeat)
- Older age and a family history of stroke
Many of these risk factors can be reduced through treatment and lifestyle changes.
Diagnosis
Doctors use a combination of tests to assess the brain and its blood vessels:
- Brain imaging: CT or MRI scans show areas of injury and can detect bleeding or blocked blood flow.
- Vessel imaging: Ultrasound of the neck arteries, CT angiography, or MR angiography shows narrowing or abnormalities in the vessels.
- Heart tests: An electrocardiogram and other tests check for irregular heart rhythms or clots that could travel to the brain.
- Blood tests: These check cholesterol, blood sugar, and clotting.
Treatment
Treatment aims to restore or protect blood flow and prevent strokes.
- Medicines: Drugs that thin the blood or prevent clots, along with treatments for blood pressure, cholesterol, and diabetes, lower the risk of stroke.
- Procedures: Narrowed neck arteries may be treated by surgery or a stent. Aneurysms may be repaired to prevent bleeding.
- Emergency stroke care: A stroke caused by a clot may be treated with clot-busting medicine or a procedure to remove the clot, but only if started quickly.
- Rehabilitation: Physical, occupational, and speech therapy help recovery after a stroke.
Managing risk factors is central to preventing further events.
Prevention
- Keep blood pressure in a healthy range
- Do not smoke, and avoid secondhand smoke
- Manage diabetes and cholesterol
- Stay physically active and maintain a healthy weight
- Eat a balanced diet low in salt and saturated fat
- Take prescribed medicines for heart rhythm or clot prevention as directed
When to See a Doctor
Call emergency services immediately if you or someone else has sudden signs of a stroke, even if they go away:
- Face drooping or weakness on one side
- Arm or leg weakness or numbness
- Slurred speech or trouble understanding
- Sudden vision loss, severe headache, or loss of balance
Fast treatment can save brain tissue and lives. For ongoing care, see a doctor to manage blood pressure, cholesterol, and other risk factors.
Frequently Asked Questions
What is cerebrovascular disease?
It is a group of conditions affecting the blood vessels that supply the brain. When these vessels are narrowed, blocked, or damaged, parts of the brain can be injured, with stroke being the most serious result.
Is cerebrovascular disease the same as a stroke?
Not exactly. Cerebrovascular disease refers to the underlying blood vessel problems, while a stroke is an event in which blood flow to part of the brain is suddenly blocked or a vessel bleeds. Cerebrovascular disease raises the risk of stroke.
What are the warning signs of a stroke?
Use FAST: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services. Other signs include sudden numbness, confusion, vision loss, severe headache, or loss of balance. Call for emergency help right away.
Can cerebrovascular disease be prevented?
Much of it can. Controlling blood pressure, not smoking, managing diabetes and cholesterol, staying active, and eating well greatly lower the risk. Taking prescribed clot-prevention medicines also helps in some people.
How is cerebrovascular disease treated?
Treatment includes medicines to control blood pressure, cholesterol, and clotting, and sometimes procedures to open narrowed arteries or repair aneurysms. Emergency stroke treatment and rehabilitation are used when a stroke occurs.
References
- Centers for Disease Control and Prevention (CDC). Stroke.
- National Institute of Neurological Disorders and Stroke (NINDS). Stroke.
- MedlinePlus, U.S. National Library of Medicine. Stroke.
- American Stroke Association. About Stroke.