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.[1] The most common presentation of cerebrovascular disease is an
ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke.[1] 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.[4] Atherosclerosis narrows blood
vessels in the brain, resulting in decreased cerebral perfusion. Other risk factors that contribute to stroke
include smoking and diabetes.[5] Narrowed cerebral arteries can lead to ischemic stroke, but continually
elevated blood pressure can also cause tearing of vessels, leading to a hemorrhagic stroke.[3]

Cerebrovascular disease

Cerebral angiogram of a carotid-cavernous fistula

Specialty

Neurology

Types

Stroke, Vascular dementia, TIA and Subarachnoid haemorrhage [1]

Diagnostic method

Neurological exam, Physical exam[2]

Treatment

Blood thinners, Anti-hypertensives[3]

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.[6] 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.[7]

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.[8] Many of these diseases can be
asymptomatic until an acute event, such as a stroke, occurs.[8] Cerebrovascular diseases can also
present less commonly with headache or seizures.[9] Any of these diseases can result in vascular
dementia due to ischemic damage to the brain.[10][11]