Vascular Syndromes of the Brain - أ.د.عمرو حسن الحسني أستاذ المخ والأعصاب

What blood vessels do cerebrovascular diseases affect?

Cerebrovascular diseases can affect both arteries and veins. The most commonly affected cerebral blood vessels that supply blood to your brain include:

Carotid arteries: These blood vessels run along the front of your neck. The majority of people have a carotid artery on the right and one on the left.
Vertebral arteries: These blood vessels run along the back of your neck. The majority of people have a vertebral artery on the right and one on the left.
What causes cerebrovascular disease?

Causes of cerebrovascular disease may include:

Blood clot that spontaneously forms in a blood vessel in your brain. This is “thrombosis” and usually happens in areas where your blood vessel is narrow or irregular.
Blood clot that travels to your brain from elsewhere in your body (embolism). The most common type of embolism is when a clot travels from your heart to your brain.
Blood vessel rupture (hemorrhage). This usually occurs in conjunction with uncontrolled high blood pressure.
Plaque build-up in the arteries (atherosclerosis) in your brain.
Structural problems in your brain’s blood vessels.
Traumatic brain injury (TBI).

What are the symptoms of cerebrovascular disease?

Symptoms of cerebrovascular disease vary depending on what area of your brain is affected. Common symptoms include:

Balance problems.
Delirium.
Fainting.
Loss of vision, visual field cut or double vision.
Paralysis or weakness on one side of your body or face.
Sudden, severe headache.
Trouble speaking or understanding speech (aphasia).
Slurred speech (dysarthria).
Sensory changes in one side of your body or face.

Diagnosis and Tests
How is cerebrovascular disease diagnosed?

Cerebrovascular disease is a medical emergency that needs a quick diagnosis. A healthcare provider will first ask about your medical history. They’ll do a physical exam to look for:

Mental status (degree of alertness and understanding of surroundings).
Abnormal eye movements or vision changes as above.
Weakness or paralysis.
Reduced or abnormal sensations.
Different aspects of speech like fluency, comprehension and naming.
Loss of balance and coordination.
Vertigo or room spinning sensation.

If your provider suspects cerebrovascular disease, they’ll sometimes use tests such as:

Cerebral angiography.
Coronary computed tomography angiogram.
Electrocardiogram (EKG).
MRI (magnetic resonance imaging).
Spinal tap (lumbar puncture).

These tests help your provider figure out the cause of the cerebrovascular disease. You might need other tests, too, depending on your situation.
Management and Treatment
How is cerebrovascular disease treated?

Treatment for cerebrovascular disease depends on your specific condition. To limit damage to your brain, you’ll need to begin treatment as soon as possible after symptoms start.

Your provider will usually treat you with medications to improve blood flow to your brain. These medications may include:

Blood pressure medications.
Blood thinners (anticoagulants).
Cholesterol-lowering drugs.
Blood sugar medications.