Cerebrovascular disease

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Cerebrovascular disease
1471-2415-12-28-1Cerebral angiogram.jpg
Classification and external resources
ICD-10 I60-I69

Cerebrovascular disease is a vascular disease of the cerebral circulation. Arteries supplying oxygen to the brain are affected resulting in one of a number of cerebrovascular diseases.[1] Most commonly this is a stroke or mini-stroke and sometimes can be a hemorrhagic stroke.[1] Any of these can result in vascular dementia.[2]

Hypertension is the most important contributing cause because it damages the blood vessel lining exposing collagen where platelets aggregate to initiate a repair.If maintained hypertension can change the structure of blood vessels ( narrow, deformed).[3]

Blood pressure affects blood flow in narrowed vessels causing ischemic stroke, a rise in blood pressure can cause tearing of vessels leading to intracranial hemorrhage.[4] For the elderly (or those who have diabetes ), the consequences of cerebrovascular disease can include a stroke, or a hemorrhagic stroke.[medical citation needed]

Associated medical condition[edit]

  • Transient ischemic attack (TIA) leaves little to no permanent damage within the brain. The symptoms of this include facial weakness, visual impairment, loss of coordination or balance, a sudden headache, and mental confusion with unintelligible speech.[5] Severe blockage of the arteries to the brain is known as carotid stenosis.[6]
  • Ischemic stroke,the most common, is due to a blood clot that completely blocks a blood vessel (in the brain).[7]

Causes[edit]

Cerebrovascular disease can be divided into embolism, aneurysms, and low flow states depending on its cause.[8] Major modifiable risk factors include:[9]

Pathophysiology[edit]

Pathophysiologically, once a stroke has occurred, voluntary control of the muscles may be lost, depending on the type of stroke the individual is encountering.[10] Strokes can also result from embolism or due to a ruptured blood vessel. Embolism blocks small arteries within the brain, causing dysfunction to occur. Spontaneous rupture of a blood vessel in the brain causes a hemorrhagic stroke.Another form of cerebrovascular disease includes aneurysms.:[medical citation needed] This can also occur with defective capillaries caused by tissue cholesterol deposition especially in hypertensive subjects with or without dyslipidemia. If bleeding occurs in this process, the resulting effect is a hemorrhagic stroke in the form of subarachnoid hemorrhage, intracerebral hemorrhage or both.[medical citation needed]

Brain Infarct

The carotid arteries cover the majority of the cerebrum. The common carotid artery divides into the internal and the external cartoid arteries. The internal carotid artery becomes the anterior cerebral artery and the middle central artery. The ACA transmits blood to the frontal parietal and a small part of the occipital lobe. From the Basillar artery are two posterior cerebral arteries. Branches of the Basillar and PCA supply the occipital lobe, brain stem, and the cerebellum.[medical citation needed] Ischemia is the loss of blood flow to the focal region of the brain. The beginning process of this is quite rapid. The duration of a stroke is usually two to fifteen minutes. One side of the face, hand, or arm may swell up. During this time, the person may lose conscious control and faint.:[medical citation needed] Brain deficits may improve over a maximum of 72 hours. Deficits do not resolve in all cases. The neurological recovery period includes stable, to improving, brain function (stable is the period by which neither nutrient supply is regained, nor is it lost.)[medical citation needed]

During ischemia, interneurons weaken, causing an insufficient amount to perform vital functions. The neuroglis becomes congested or maintains loss during a cerebrovascular accident. Neural pathways weaken, therefore decreasing action potential. The neural arc, which in general consists of sensory and motor neurons, weakens as well. :[medical citation needed] The muscles become paralyzed, in some cases for life. Paralysis also includes the weakening of the receptors in the body, unless improvement is made. Cerebrovascular damage to the brain is what makes it difficult for receptors to receive the impulse and transmit to neurons. This chemical reaction is then transmitted creating a poor reflex to the body. The meninges that also protect the brain and spinal cord, are deeply weakened, allowing the individual to suffer vast transmission of diseases.[medical citation needed]

Evaluation[edit]

Diagnosis of cerebrovascular disease if done by:[11]

Treatment[edit]

Treatment for cerebrovascular disease includes:[4]

Epidemiology[edit]

Disability-adjusted life year for cerebrovascular disease per 100,000 inhabitants in 2004.[12]
  less than 250
  250–425
  425–600
  600–775
  775–950
  950–1125
  1125–1300
  1300–1475
  1475–1650
  1650–1825
  1825–2000
  more than 2000

The most common forms of cerebrovascular disease are cerebral thrombosis (40% of cases) and cerebral embolism (30%), followed by cerebral hemorrhage (20%).:[medical citation needed]

Cerebrovascular disease primarily occurs with advanced age; the risk for developing it goes up significantly after 65. CVD tends to occur earlier than Alzheimer's Disease (which is rare before the age of 80). In some countries such as Japan, CVD is more common than AD.[medical citation needed]

The amount of individuals ( adults) who had a stroke is 6.4 million, in 2012, this corresponds to 2.7% in the U.S. With approximately 129,000 deaths in 2013 (U.S.)[13]

References[edit]

  1. ^ a b c "Cerebrovascular disease - Introduction - NHS Choices". www.nhs.uk. Retrieved 2015-09-01. 
  2. ^ "Vascular dementia - Causes - NHS Choices". www.nhs.uk. Retrieved 2015-09-01. 
  3. ^ Prakash, Dibya (2014-04-10). Nuclear Medicine: A Guide for Healthcare Professionals and Patients. Springer Science & Business Media. p. 142. ISBN 9788132218265. 
  4. ^ a b "Stroke: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-09-01. 
  5. ^ "Transient Ischemic Attack Information Page: National Institute of Neurological Disorders and Stroke (NINDS)". www.ninds.nih.gov. Retrieved 2015-09-01. 
  6. ^ "Carotid Artery Stenosis information. Internal carotis occlusion | Patient". Patient. Retrieved 2015-09-01. 
  7. ^ "Stroke: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-09-01. 
  8. ^ Corporation, Surgisphere. Clinical Review of Surgery | ABSITE Review. Lulu.com. p. 146. ISBN 9780980210347. 
  9. ^ "Cerebrovascular disease - NHS Choices - Risks and prevention". www.nhs.uk. Retrieved 2015-09-01. 
  10. ^ Information, National Center for Biotechnology; Pike, U. S. National Library of Medicine 8600 Rockville; MD, Bethesda; Usa, 20894. "Stroke - National Library of Medicine". PubMed Health. Retrieved 2015-09-01. 
  11. ^ "Stroke. Diagnosis and Therapeutic Management of Cerebrovascular Disease | Revista Española de Cardiología (English Version)". www.revespcardiol.org. Retrieved 2015-09-01. 
  12. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov 11, 2009. 
  13. ^ "FastStats". www.cdc.gov. Retrieved 2015-09-01. 

Further reading[edit]