Cerebrovascular Disease

Cerebrovascular disease includes all diseases in which an area of the brain is temporarily or permanently affected by ischemia (lack of blood) or bleeding, and one or more of the cerebral blood vessels are damaged or diseased.

The brain relies on the carotid and vertebral arteries for its blood supply. Often, the underlying cause of a stroke is carotid arteries blocked with a fat buildup called plaque. This blockage reduces blood going to the brain and increases the risk of a stroke. During a stroke, an artery in or on the brain's surface has ruptured or leaked, causing bleeding and damage in or around the brain.

The brain must get enough blood flow and oxygen as soon as possible. Without oxygen and important nutrients, the affected brain cells are either damaged or die within a few minutes.Once brain cells die, they cannot come back, and damage may lead to physical, cognitive, and mental disabilities.

What happens once you have cerebrovascular disease?

Restrictions in blood flow may happen because of vessels narrowing (stenosis), clotting (thrombosis), being blocked (embolism), or ruptured (hemorrhage). Lack of sufficient blood flow affects brain tissue and may cause a stroke.

Cerebrovascular disease includes stroke, carotid stenosis, vertebral stenosis, intracranial stenosis, aneurysms, and vascular malformations.

The way cerebrovascular disease develops depends on the location of the blockage and its impact on brain tissue. Common symptoms of cerebrovascular diseases include:

• Confusion.


• Loss of balance.


• Losing vision on one side.


• Becoming unconscious.


• A severe and sudden headache.


• Paralysis of one side of the body, or hemiplegia.


• Weakness on one side, known as hemiparesis.


• Difficulty communicating, including slurred speech.

It is a medical emergency when anyone shows a cerebrovascular attack symptoms because it can cause long-term problems, such as cognitive impairment and paralysis.

What causes cerebrovascular disease?

Atherosclerosis is a primary cause of cerebrovascular disease. It occurs when high cholesterol levels and inflammation in the brain's arteries cause cholesterol to build up as a thick, waxy plaque that narrows or blocks blood flow in the arteries. This can cause a cerebrovascular attack, such as a stroke or TIA (transient ischemic attack).

Damaged blood vessels are another common cause of cerebrovascular disease. Damaged blood vessels in the brain mean that the brain will not receive enough blood from the heart. The lack of blood means less oxygen and, without oxygen, brain cells will die.

What types of tests are used to diagnose cerebrovascular disease?

At the hospital, a doctor will ask about your medical history and look for specific problems, including:

• Slower reflexes.


• Muscle weakness.


• Abnormal eye movements.


• Changes in vision or visual fields.


• Change in sensations like numbness or being more sensitive to cold.

A doctor may use different tests to diagnose the type of cerebrovascular disease you have. These tests include:

Cerebral angiography: A catheter (a long, narrow, flexible tube) is inserted through the needle and into the artery. It is then threaded to the arteries of the neck. The contrast dye is then injected into the neck, and X-ray pictures are taken.

• Carotid duplex: This ultrasound helps detect plaque, blood clots, or other problems with blood flow in the carotid arteries. A water-soluble gel is placed on the skin where a handheld device is placed. Images of the carotid arteries and pulse waveforms will appear on the monitor.

• Computed tomography (CT scan): A diagnostic image is created after a computer reads x-rays. This is a useful diagnostic test for hemorrhagic strokes because it shows blood flow.

• Doppler ultrasound: This ultrasound evaluates the superficial and deep venous systems. There is a "swishing" sound on the Doppler if the venous system is normal.

• Electroencephalogram (EEG): This test uses small metal discs (electrodes) placed on a person's scalp to pick up electrical impulses. These electrical signals are printed out as brain waves.

• Magnetic Resonance Imaging (MRI): This test produces 3D images of body structures using magnetic fields and computer technology. It can show nerve tissue and clear pictures of the brain stem and posterior brain to detect signs of prior mini-strokes.

• Magnetic Resonance Angiogram (MRA): A computer assembles the magnetic images to provide an image of the arteries in the head and neck to detect blockage and aneurysms.

What types of treatments and procedures are used to treat cerebrovascular disease?

A cerebrovascular event is a medical emergency. Rapid treatment is crucial to avoid brain damage.

• Medication: In the case of a stroke, the doctor may administer a medication that breaks up blood clots.

• Surgery: For a brain hemorrhage, a neurosurgeon (brain surgeon) may conduct surgery to reduce the increased blood pressure in your brain.

Two common surgeries include:

• A carotid endarterectomy, which involves making an incision in the carotid artery (side of the neck) and removing plaque, may be done to improve blood flow.

• A carotid angioplasty and stenting, which involves a surgeon inserting a balloon-tipped catheter into the artery to improve blood flow.

What can I do to support my health when I have cerebrovascular disease?

Prompt treatment and lifestyle changes that reduces cerebrovascular disease risk are the best ways to improve the outlook for a person with cerebrovascular disease. 

Why choose Presbyterian for cerebrovascular disease treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.