Cerebrovascular Disease

What is cerebrovascular disease?

Cerebrovascular disease is an umbrella term for conditions that impact the blood vessels in your brain. “Cerebro” refers to your brain and “vascular” refers to your blood vessels (arteries and veins).

Cerebrovascular diseases may cause a reduction of blood flow to your brain (ischemia) or bleeding (hemorrhage) in a part of your brain. Both conditions are generally referred to as “stroke.” Blood vessel diseases in the brain can lead to strokes, as well as many other vascular conditions.

If you or your loved one have a cerebrovascular disease, it’s important to restore blood flow to the brain as soon as possible. Otherwise, brain cells can quickly die and cause permanent disability or death.

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 are the types of cerebrovascular disease?

Stroke is the most common type of cerebrovascular disease. Other types of cerebrovascular disease include, but aren’t limited to:

• Arteriovenous malformation (AVM).
• Brain aneurysm.
• Brain bleed, hemorrhage (intracranial hemorrhage).
• Carotid artery disease (carotid artery stenosis).
• Cervical artery dissection.
• Reversible cerebral vasoconstriction syndrome.
• Subarachnoid hemorrhage (SAH).
• Transient ischemic attack (TIA) or mini stroke.
• Hereditary hemorrhagic telangiectasia (HHT).
• Moyamoya disease.

Who might have cerebrovascular disease?

People of every sex, age and race can have cerebrovascular disease. There are certain uncontrollable factors that put some people at higher risk for cerebrovascular disease, such as age or biological sex.

How common is cerebrovascular disease?

Cerebrovascular disease is the most common type of life-threatening injury to the brain in the U.S. and the fifth most common cause of death. In 2020, cerebrovascular disease led to more than 160,000 deaths in the U.S.

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.

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.

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.

If you have severe blockage in your blood vessels, you may need surgery. Types of surgery may include:

• Carotid angioplasty, where your surgeon inflates a balloon-tipped catheter inside of your artery to open it.
• Carotid endarterectomy, where your surgeon makes a cut (incision) in your carotid artery to remove plaque.
• Carotid stenting, when your surgeon inserts a narrow metal tube (stent) into your carotid artery to improve blood flow.
• Catheter-directed mechanical thrombectomy, when your surgeon inserts a catheter into your artery along with a device to suck out the blood clot.

How can I reduce my risk of cerebrovascular disease?

You can lower your risk of cerebrovascular disease by following a healthy lifestyle. It’s smart to:

• Control high blood pressure (hypertension).
• Eat a hypertension diet low in salt, fat and calories.
• Exercise.
• Limit your intake of alcohol.
• Don’t use recreational drugs.
• Maintain a healthy weight.
• Manage your sugar and cholesterol levels.
• Quit smoking.
• Reduce stress.
• See your provider for regular checkups.
• Take a blood thinner if needed for conditions such as heart arrhythmia.
• Weigh the risk of blood clots vs. the benefits of hormone therapy for menopause symptoms.

Are there other conditions that may put me at higher risk?

Overall, you’re at higher risk of cerebrovascular disease if you have:

• Diabetes.
• High blood pressure.
• High cholesterol.

You may be at higher risk of certain types of cerebrovascular disease if you:

• Are pregnant, which increases your risk of cerebral venous thrombosis.
• Have an inherited (congenital) medical condition, which increases your risk of a brain aneurysm, amongst other vascular conditions.
• Have a traumatic brain injury.
• Take hormone replacement therapy (HRT), which can increase your risk of stroke if you have atherosclerosis or carotid artery disease.

What can I expect if I have cerebrovascular disease?

People with controlled cerebrovascular disease can often lead normal lives with complete recovery. In some cases, cerebrovascular disease may lead to death or disability. Complications may include:

• Aphasia or difficulty finding words.
• Gait disorders.
• Memory loss.
• Paralysis or weakness in your face, arms or legs.
• Temporary or permanent mental disability.
• Trouble thinking and reasoning (cognitive impairment).

What is the outlook if I have cerebrovascular disease?

As stated above, some people go on to achieve full recovery while others have persistent deficits. If you have cerebrovascular disease, the outlook depends on:

• How fast you receive treatment.
• Severity of the condition or size of the stroke.
• Area of the brain affected.
• Type of cerebrovascular disease.

How do I take care of myself with cerebrovascular disease?

You can continue to take care of yourself with cerebrovascular disease by:

• Leading a healthy lifestyle.
• Taking medications to treat any underlying conditions.

If cerebrovascular disease has affected your brain function, you may need rehabilitative therapies to help you, such as:

• Occupational therapy.
• Physical therapy.
• Psychological therapy.
• Speech therapy.

When should I see my healthcare provider?

Call 911 immediately if you notice any symptoms of cerebrovascular disease. The American Stroke Association suggests using the acronym F.A.S.T. to identify symptoms:

• Face drooping.
• Arm weakness.
• Speech difficulty.
• Time to call 911.

Also, see your provider with any concerns about side effects from your treatments or if you don’t notice results after some time. They’ll be able to suggest other treatments that may help.

A note from Cleveland Clinic

Cerebrovascular disease is a term for conditions that affect the blood vessels that supply blood to your brain. This decreases the amount of oxygen that reaches the brain causing damage. The most common one is stroke. Other conditions include brain aneurysms, brain bleeds, carotid artery disease and transient ischemic attacks (TIA) or mini strokes, among others. Possible symptoms include balance issues, vision loss, headaches and difficulty speaking. Your provider can treat cerebrovascular disease with medications and surgery. You can also lower your risk by making lifestyle changes, such as doing more exercise and reducing stress. Although cerebrovascular disease can cause disability and death, many people do continue to lead full lives. Your chances are better if you receive prompt treatment.