Cerebrovascular Disease: Causes, Symptoms, Risk Factors and Treatment
How do strokes (cardiovascular accidents) occur?
Strokes or brain damage may occur because of one of the following:
- Bleeding due to a rapid rise in blood pressure, resulting in the rupture of a vessel.
- A clot is formed in an atherosclerotic vessel.
- An embolus lodged in a brain artery, resulting in the infarction (death) of the area supplied by that vessel.
The brain may be damaged by hemorrhage or rendered ischemic by an inadequate blood supply.
What are the risk factors of Cerebrovascular Diseases?
- Vascular disease
Pathological changes are present in one or more of the arteries supplying the brain. This may be a local abnormality, such as an aneurysm, or part of a more widespread arterial disease, such as atherosclerosis, which is usually associated with hypertension.
- Circulatory dynamics
Hemorrhage occurs if pressure rises rapidly in a diseased vessel, and existing hypertension makes it more likely. Conversely, if the pressure falls excessively, the flow of blood through a narrowed vessel may be insufficient to enable the proper functioning of the brain. Temporary ischemia causes a temporary neurological disturbance, but if ischemia lasts for more than a few minutes infarction of the brain occurs. Low blood pressure also increases the risk of thrombosis Infarction may also occur if a major blood vessel is occluded by the impaction of an embolus without any underlying vascular disease in the brain.
- Clotting disorders
Spontaneous clotting may occur in cerebral vessels and bleeding disorders may cause bleeding in the brain.
What are the symptoms of Cerebrovascular Disease?
In cerebral atherosclerosis, the onset of symptoms is insidious. There is a progressive impairment of the higher intellectual functions, such as intellectual capacity, memory for recent events, judgment, emotional ability, and self-control. Physical symptoms may occur as the sole abnormality. Speech may be affected and the paralysis of one or more limbs may occur. Some patients may have epileptic fits.
How do we treat Cerebrovascular Disease?
There is no specific treatment, but much can be done to avoid difficulties. If there is any associated hypertension, it needs to be controlled with drugs, and diet and obese patients will benefit if they control their weight. Physiotherapy is useful for patients with hemiplegia or other neurological deficits.