Q 2.16. Cerebrovascular diseases. Classification

1. Cerebrovascular Disease Overview:

    • The term “cerebrovascular” refers to blood flow in the brain. It encompasses all disorders where an area of the brain is affected by either ischemia (reduced blood flow) or bleeding. These conditions involve one or more cerebral blood vessels.
    • Common cerebrovascular diseases include:
      • Stroke: A sudden interruption of blood flow to the brain due to clot formation (ischemic stroke) or vessel rupture (hemorrhagic stroke).
      • Carotid Stenosis: Narrowing of the carotid arteries (located in the neck) that supply blood to the brain.
      • Vertebral Stenosis: Narrowing of the vertebral arteries (alongside the spinal column) that also contribute to brain blood supply.
      • Intracranial Stenosis: Narrowing within the cerebral blood vessels.
      • Aneurysms: Weak sections in blood vessel walls that cause bulging.
      • Vascular Malformations: Abnormalities in blood vessels.

In elderly patients, chronic cerebrovascular disease can manifest as multiple brain infarcts visible on CT scans. These infarcts are often associated with a history of cerebrovascular risk factors such as hypertension, diabetes mellitus, hyperlipidemia, and smoking.


2. Blood Flow to the Brain:

    • The brain receives blood through two major sets of arteries:
      • Carotid Arteries: Located in the neck, they split into external and internal branches. The internal carotid arteries supply blood to the brain.
      • Vertebral Arteries: Extend alongside the spinal column and join to form the basilar artery near the brain stem.
    • Proper blood flow is crucial for brain health.



3. Clinical Importance:

      • Ischemic strokes often result from carotid artery blockages caused by plaque buildup.
      • Hemorrhagic strokes occur due to artery rupture or leakage.
      • Rapid restoration of blood flow and oxygen to the brain is essential to prevent irreversible damage.


The symptoms of chronic cerebrovascular disease in elderly individuals can include:

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

These symptoms are indicative of underlying issues with blood flow to the brain and can lead to serious conditions like stroke. It’s important for healthcare providers to recognize these symptoms promptly as they may require immediate medical attention.

Remember, understanding cerebrovascular diseases is vital for medical professionals to diagnose, treat, and prevent these conditions effectively. Early detection and management of risk factors are key to reducing the burden of this disease.



1 aans.org

2 health.ucdavis.edu

3 nm.org

4 uofmhealth.org

5 apps.who.int

Verified by Dr. Petya Stefanova