Cerebrovascular disease is a term that encompasses a variety of ailments, diseases, and disorders that affect the brain’s blood arteries and blood flow.
If the brain cells are deprived of oxygen due to a blockage, malformation, or hemorrhage, brain injury can occur.
Cerebrovascular disease can be caused by a number of causes, including atherosclerosis, in which the arteries narrow; thrombosis, or embolic arterial blood clot, in which a blood clot forms in a brain artery; and cerebral venous thrombosis, in which a blood clot forms in a brain vein.
Stroke, transient ischemic attack (TIA), aneurysm, and vascular malformation are all examples of cerebrovascular disorders.
Cerebrovascular disease is the sixth leading cause of mortality in the United States. In 2017, it resulted in 44.9 deaths per 100,000 people, totaling 146,383 deaths.
People can, however, take actions to lower their risk of acquiring cerebrovascular disease. We’ll go through the symptoms, kinds, and treatments for these major health issues, as well as how to avoid them, in this post.
Causes
Cerebrovascular disease can be caused by a number of factors.
If a blood artery in the brain is damaged, it will be unable to provide enough or any blood to the brain region it serves. The absence of blood obstructs the supply of necessary oxygen to brain cells, which causes them to die.
Damage to the brain is irreversible. Emergency assistance is critical in reducing the likelihood of long-term brain damage and increasing a person’s chances of life.
Cerebrovascular disease is mostly caused by atherosclerosis. This happens when high cholesterol levels combine with inflammation in the brain’s arteries, causing cholesterol to form a thick, waxy plaque that narrows or blocks blood flow.
This plaque can restrict or totally block blood flow to the brain, resulting in a cerebrovascular event such as a stroke or transient ischemic attack (TIA).
Types
Cerebrovascular disease includes stroke, transient ischemic attack, and subarachnoid hemorrhage.
Aneurysms and hemorrhages can be dangerous to one’s health. A blockage can occur when blood clots develop in the brain or migrate there from other parts of the body.
Cerebrovascular disease comes in a variety of forms, including:
Ischemic stroke: A blood clot or atherosclerotic plaque stops a blood artery that provides blood to the brain, resulting in a stroke. A clot, or thrombus, can develop in an already narrowed artery.
A stroke happens when the brain cells die due to a lack of blood flow.
Embolism: The most frequent form of ischemic stroke is an embolic stroke. When a clot from elsewhere in the body breaks off and goes to the brain, it blocks a smaller artery.
Arrhythmias, or irregular heart people, increase the risk of embolism.
Ischemic stroke can be caused by a rupture in the lining of the carotid artery in the neck. The rip allows blood to travel between the carotid artery’s layers, narrowing it and limiting blood flow to the brain.
Hemorrhagic stroke: When a blood artery in a portion of the brain becomes weak and breaks open, blood leaks into the brain.
The leaking blood puts pressure on the brain tissue, causing edema and brain tissue damage. Nearby parts of the brain may also lose their supply of oxygen-rich blood as a result of the hemorrhage.
Cerebral aneurysm or subarachnoid hemorrhage: These can be caused by structural issues with the brain’s blood arteries. An aneurysm is a weakened area of the artery wall that can burst and cause bleeding.
When a blood artery ruptures and bleeds between two membranes covering the brain, it is known as a subarachnoid hemorrhage.
The leakage of blood has the potential to harm brain cells.
Learn more about a thrombus, which can lead to an embolism, in this article.
Symptoms
The symptoms of cerebrovascular disease vary depending on where the blockage is located and how it affects brain tissue.
Different events may have different consequences, however the following are frequent symptoms:
- losing vision on one side
- loss of balance
- becoming unconscious
- paralysis of one side of the body, or hemiplegia
- weakness on one side, also known as hemiparesis
- a severe and sudden headache
- confusion
- difficulty communicating, including slurred speech
Response to an emergency
The American Stroke Association promotes public awareness of the F.A.S.T. acronym as a tool for detecting and responding to stroke warning signs:
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
If somebody displays symptoms of a cerebrovascular stroke, they should get medical help right away since it can have long-term consequences including cognitive damage and paralysis.
Risk factors
The most frequent form of cerebrovascular incident is a stroke.
Stroke risk rises with age, especially if a person or a close family has already experienced a cerebrovascular event. Between the ages of 55 and 85, this risk doubles every ten years.
A stroke, on the other hand, can strike at any age, including infancy.
Stroke and other kinds of cerebrovascular disease are caused by a number of factors, including:
- obesity
- poor diet, and lack of exercise
- diabetes
- blood cholesterol levels of 240 milligrams per deciliter (mg/dl) or higher
- hypertension, which the American College of Cardiology define as blood pressure of 130/80 mm Hg or higher
- smoking
A person’s chances of developing a cerebral aneurysm are increased by the same circumstances. People who have a congenital abnormality or have had head trauma, on the other hand, may be at a higher risk of developing a cerebral aneurysm.
Cerebral venous thrombosis, a blood clot affecting a vein in the brain, can also be increased by pregnancy.
Other cerebrovascular disease risk factors include:
- a vein of Galen malformation, an arterial disorder that develops in a fetus during pregnancy
- venous angiomas, which affect around 2% of the U.S. population and rarely bleed or cause symptoms
- Moyamoya disease, a progressive condition that can lead to a blockage of the cerebral arteries and their major branches
Certain medications and medical conditions can cause blood to clot more easily, increasing the risk of ischemic stroke.
In people who currently have atherosclerosis or carotid artery disease, hormone replacement treatment (HRT) may raise the risk of a heart attack.
Find out what strokes are and how to spot them.
Treatment
A cerebrovascular episode need immediate medical attention. Because a person must get stroke drugs within a specified time frame from the beginning of symptoms, rapid assessment and treatment are critical.
In the event of an acute stroke, the emergency team may deliver tissue plasminogen activator (tPA), a drug that dissolves the blood clot.
A brain hemorrhage requires the attention of a neurosurgeon. They may do surgery to relieve the increased pressure caused by a bleed.
A carotid endarterectomy is a procedure that includes cutting a hole in the carotid artery and removing plaque. This re-establishes blood flow. The artery is then repaired with stitches or a graft by the surgeon.
Carotid angioplasty and stenting, which includes a surgeon putting a balloon-tipped catheter into the artery, may be necessary for some people. The balloon will subsequently be inflated to reopen the artery.
The surgeon next inserts a thin metal mesh tube, known as a stent, into the carotid artery to increase blood flow in the previously occluded artery. After the treatment, the stent keeps the artery from collapsing or shutting up.
Rehabilitation
People may endure temporary or permanent incapacity as a result of a cerebrovascular accident, which can cause lasting brain damage.
As a result, they may need a variety of supportive and rehabilitative therapies in order to maintain as much function as feasible.
These might include the following:
- Occupational therapy: This can assist a person in gaining access to resources that will enable them return to employment and daily life.
- Psychological therapy: Physical disabilities might result in unforeseen emotional demands that need extensive retraining. If a person feels overwhelmed following a cerebrovascular incident, they may benefit from seeing a psychiatrist, psychologist, or counselor.
- Physical therapy: This seeks to improve limb function, mobility, and flexibility.
- Speech therapy: After a stroke or a cerebrovascular episode, this may help people speak more effectively and restore speech.
Find out all about physical therapy here.
Reducing the risk of stroke
Blood platelet inhibitors like Dipyridamole, Ticlopidine, and Clopidogrel can help prevent strokes before they happen. These can help prevent stroke in people who have had a stroke before or who have a high risk of developing one
Doctors used to suggest that people take aspirin every day to lower their risk of heart attack or stroke. Current guidelines, on the other hand, recommend that people take aspirin only if they are at high risk of a cardiovascular event and have a low risk of bleeding.
This is due to the fact that aspirin raises the risk of bleeding.
Statins are drugs that are prescribed by doctors to lower and control high cholesterol levels and reduce the risk of ischemic stroke and heart attack.
Diagnosis
Any cerebrovascular incident is a medical emergency, and anybody who notices the symptoms should call 911 for assistance. The importance of early detection in preventing brain injury cannot be overstated.
A doctor will inquire about the patient’s medical history and look for particular neurological, motor, and sensory problems, such as:
- abnormal eye movements
- muscle weakness
- changes in vision or visual fields
- decreased sensation
- reduced or altered reflexes
A vascular abnormality, such as a blood clot or a blood artery defect, can be detected using a cerebral angiography, vertebral angiogram, or carotid angiogram. Injecting dye into the arteries reveals any clots and allows CT or MRI imaging to show their size and form.
Because it can distinguish between blood, bone, and brain tissue, a CAT scan can aid in the diagnosis and detection of hemorrhagic strokes. However, especially in the early phases of an ischemic stroke, it does not always detect damage.
Even early-stage strokes can be detected with an MRI scan.
A cardiac arrhythmia, which is a risk factor for embolic strokes, can be detected by an electrocardiogram (EKG or ECG).
Prevention
The following are some methods for lowering the risk of cerebrovascular disease:
- getting at least 150 minutes of moderate to vigorous physical activity every week is recommended
- maintaining a healthy body weight by consuming a balanced diet that promotes vascular health, such as the DASH diet, as recommended by the National Heart, Lung, and Blood Institute
- stop smoking
- managing blood cholesterol and blood pressure with diet and medications if necessary
People who have heart arrhythmia should talk to their doctor about whether or not they should take a blood thinner to avoid strokes.
Although stroke and other cerebrovascular events can result in death, full or partial recovery is possible with prompt medical intervention. To lower the risk of a stroke, people with cerebrovascular disease should follow healthy lifestyle advice and their doctor’s instructions.
Conclusion
The outlook is determined by the sort of occurrence, its intensity, and the speed with which a person receives care.
Cerebrovascular disease can kill someone or leave you disabled for a long time. Some people, on the other hand, will fully recover.
The greatest approaches to enhance a person’s outlook with cerebrovascular disease are prompt treatment and a lifestyle that decreases the chance of stroke.
Sources:
- http://www.onlinejacc.org/content/accj/early/2019/03/07/j.jacc.2019.03.010.full.pdf
- https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
- https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Preventing-Stroke#Risk%20Factors
- https://www.nhlbi.nih.gov/health-topics/carotid-endarterectomy
- https://www.medicalnewstoday.com/articles/184601
- https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Cerebrovascular-Disease
- https://www.cdc.gov/nchs/fastats/stroke.htm
- https://www.nhlbi.nih.gov/health-topics/dash-eating-plan
- https://www.strokeassociation.org/en/about-stroke/stroke-symptoms
- https://www.strokeassociation.org/en/about-stroke/treatment#.WBMLG5MrJTY
