Cerebrovascular diseases affect blood vessels in the brain, causing issues like stroke or aneurysms. They disrupt blood flow and oxygen, leading to serious health problems.
What is cerebrovascular disease?
Cerebrovascular diseases are conditions affecting the blood vessels in the brain. Cerebrovascular refers to anything related to the blood vessels that supply the brain. "Cerebro" means brain, and "vascular" relates to blood vessels. So, when you see cerebrovascular disease, that is any condition related to brain's blood supply.
Strokes and brain hemorrhages fall under this category, but cerebrovascular diseases also include these conditions and others:
- Carotid artery stenosis
- Vertebral stenosis
- Aneurysms
- Vascular malformations
- Brain bleed
- Cervical artery dissection
- Transient ischemic attack
- Arteriovenous malformation
- Cerebral venous thrombosis
At AHN, our team brings together a high level of skill and deep understanding of cerebrovascular conditions. We are committed to exploring advanced treatment options to tailor care that addresses your specific needs. Our focus is on providing comprehensive support as we work to manage your cerebrovascular disease.
AHN Stroke Centers
AHN Neuroscience provides diagnosis and treatment of cerebrovascular conditions and injuries at multiple clinic and hospital locations throughout western Pennsylvania and Erie. Our board-certified neurologists, vascular neurosurgeons, and specialists work together to help patients with cerebrovascular conditions find and get the treatment options they need at our certified primary and comprehensive AHN Stroke Centers.
Why choose AHN for your cerebrovascular disease
If you or a loved one needs expert, specialized care for a cerebrovascular condition, the AHN Neuroscience team provides advanced treatments throughout western Pennsylvania and Erie. We work to deliver the best health outcomes and personalized care after a cerebrovascular injury or diagnosis with our:
- Expertise: Our network of stroke centers includes the Comprehensive Stroke Center at Allegheny General Hospital, which is designated with the highest distinction of stroke care that’s awarded by the Joint Commission, a nonprofit that independently accredits and reviews health care organizations. Allegheny General Hospital was one of the first medical centers in the country to earn this designation, recognizing our commitment to advanced stroke care.
- Experience: AHN’s highly skilled team has extensive experience performing advanced stroke therapy, caring for more than 2,500 patients with cerebrovascular conditions each year. We take care of patients requiring intricate treatments related to ischemic stroke or other conditions causing brain hemorrhage.
- Team approach: Our neurologists, neurosurgeons, and interventional radiologists work together and coordinate your personalized treatment plan, so the entire team understands what your care plan requires. This team effort improves the chances of a full recovery while decreasing neurological disability.
Our commitment to cerebrovascular disease care
At AHN, we’ll create a care plan for you that includes our:
- Urgent stroke care capabilities: Our acute stroke-response team uses telestroke consultations to support physicians treating acute stroke in local community hospitals throughout western Pennsylvania. With this telemedicine technology and training, our neurologists can provide immediate assessments and treatment plans for patients with complex needs.
- Comprehensive follow-up: Our stroke care team manages treatments for people disabled by a stroke, improving the level of follow-up care that patients receive after hospitalization. We support our patients during their recovery, whether they return home with home care services or receive continued care at acute rehab facilities or skilled nursing facilities.
- Coordinated care: We coordinate your care at every point, from the onset of a stroke through recovery. An electronic health record system and patient portal, MyChart, allows you to access your medical records, view test results, and communicate with your physicians about any concerns.
- Focus on research: You may be able to participate in clinical trials studying the treatment and prevention of cerebrovascular conditions. These trials give you access to some of the latest therapies related to brain hemorrhage and stroke care.
We understand the urgency and long-term journey involved with cerebrovascular conditions. Our AHN team provides fast and supportive care while always focusing on your well-being and recovery.
Cerebrovascular disease symptoms and signs
Understanding the symptoms and signs that are often associated with cerebrovascular disease can be crucial in early diagnosis and treatment. General symptoms and signs can often appear suddenly and can be remembered by using the acronym B.E.F.A.S.T. Look for or be aware of these B.E.F.A.S.T. signs:
- Balance loss: A loss of balance, dizziness, or trouble walking that comes on suddenly.
- Eye vision changes: Sudden loss of vision or experiencing blurred vision.
- Face drooping: One side of the face may droop or be numb. The person's smile may be uneven.
- Arm weakness: One arm may be weak or numb. When trying to raise both arms, one arm may drift downward.
- Speech difficulty: Speech may be slurred, or the person may be unable to speak or be hard to understand. They might also have trouble understanding speech.
- Time to call emergency services: If any of these signs are observed, even if they disappear, it's crucial to seek immediate medical attention.
Other common symptoms and signs can often include:
- Sudden weakness or numbness: This can affect the face, arm, or leg, typically on one side of the body.
- Sudden confusion or trouble understanding: Difficulty speaking, understanding speech, or disorientation.
- Sudden vision problems: Blurred vision, double vision, or loss of vision in one or both eyes. This can sometimes be described as a "curtain coming down" over the eye (amaurosis fugax), particularly with carotid artery issues.
- Sudden trouble walking: Dizziness, loss of balance or coordination, or stumbling.
- Sudden, severe headache with no known cause: This is often described as the "worst headache of my life" and can be a sign of a hemorrhagic stroke (bleeding in the brain).
- Vertigo or dizziness: A sensation of spinning or imbalance.
- Difficulty swallowing (dysphagia): Trouble with food or liquid going down, which can lead to choking.
It's crucial to remember that any sudden neurological symptom should be considered a medical emergency. Prompt medical attention can significantly improve outcomes, especially for stroke.
Causes and risk factors
When the blood vessels of the brain become blocked or damaged, there is risk for cerebrovascular disease. The blockages or damages can happen over time and be caused by a variety of medical conditions and lifestyle factors. There are also genetic factors that can increase a person’s risk for developing cerebrovascular disease. Understanding these and being aware of the causes and risk factors can help you detect issues earlier that can hopefully lead to better health outcomes.
Medical conditions
Medical conditions that lead to the accumulation of plaque made up of fat and cholesterol (atherosclerosis) buildup in the arteries and blood vessels and can increase the risk or cause cerebrovascular disease. These medical conditions often include:
- High blood pressure (hypertension): Damages blood vessels over time, making them prone to atherosclerosis and reducing elasticity. Learn more about high blood pressure.
- High cholesterol: Contributes to the formation of atherosclerotic plaque. Learn more about high cholesterol.
- Diabetes: High blood sugar damages blood vessels and promotes atherosclerosis.
- Atrial Fibrillation (AFib): Significantly increases the risk of stroke and transient ischemic attack (TIA) due to clot formation in the heart. Learn more about AFib.
- Carotid artery disease: Pre-existing narrowing of the carotid arteries due to plaque. Learn more about carotid artery disease.
- Previous TIA or stroke: Having had one TIA or stroke significantly increases the risk of additional events. A TIA is a strong warning sign.
- Other heart diseases: Heart failure, previous heart attack, and heart valve problems can all increase stroke risk.
Lifestyle
Certain lifestyle choices can damage your health. Making changes for better health can reduce the risk of developing cerebrovascular disease. These health conditions or lifestyle choices include:
- Smoking: Damages blood vessel walls, thickens blood, increases blood pressure, and reduces oxygen delivery.
- Obesity: Contributes to high blood pressure, diabetes, and high cholesterol.
- Lack of physical activity: Increases the risk of obesity and related conditions.
- Unhealthy diet: Diets high in saturated and trans fats, cholesterol, and sodium increase the risk of obesity-related health conditions.
- Excessive alcohol consumption: Can raise blood pressure and contribute to AFib.
- Illicit drug use: Especially cocaine and amphetamines, which can cause sudden spikes in blood pressure and vasospasm.
Other risk factors
Certain risk factors outside of your control can lead to cerebrovascular disease. Knowing your risk and talking with your doctor about your health history and family health history can be helpful in your treatment plan. Risk factors include:
- Age: The risk of stroke increases significantly with age.
- Family history: A family history of stroke or TIA increases your own risk.
- Race/ethnicity: African Americans, Hispanic Americans, and Native Americans have a higher risk of stroke often due to higher rates of high blood pressure, diabetes, and sickle cell disease.
- Sex: Stroke is more common in those assigned female at birth, especially at older ages. Pregnancy and hormone therapy can also affect risk.
- Prior stroke or TIA: Having had a stroke or TIA significantly increases the risk of future events.
- Certain medical conditions: These can include sickle cell disease, fibromuscular dysplasia, and others.
Cerebrovascular disease screening and diagnosis
At AHN, the screening and diagnosis process to determine the risk of or presence of cerebrovascular disease typically involves evaluating risk factors, conducting physical and neurological exams, and using various imaging and diagnostic tests. Our team will work to get a full picture of your health, so we can create a tailored treatment plan. This usually involves a combination of the following information and exams:
- Medical history: Past strokes, TIAs, heart disease, diabetes, high blood pressure, and high cholesterol.
- Family history: History of stroke or heart disease in close relatives.
- Lifestyle factors: Smoking, diet, physical activity, and alcohol use.
- Physical exam: Checking blood pressure, listening to the heart, and sometimes listening for a "bruit" (a whooshing sound) over the carotid arteries in the neck, which can indicate turbulent blood flow due to narrowing.
- Carotid ultrasound (duplex scan): This is an imaging test that uses sound waves to create images of the carotid arteries in the neck. It's often used to screen for carotid artery stenosis in individuals with risk factors, especially those with a history of heart disease, peripheral artery disease, or unexplained neurological symptoms.
After screening, we can work to determine a diagnosis. Diagnosis typically occurs when someone shows symptoms suggestive of a stroke, transient ischemic attack (TIA), or other cerebrovascular event. The goal is to rapidly confirm the diagnosis, determine the type of cerebrovascular event (e.g., ischemic stroke, hemorrhagic stroke), locate the affected area, and identify the underlying cause. Diagnosis is usually done through:
- Physical and neurological check-up: Your doctor will ask you questions and do a hands-on exam to check things like your alertness, speech, vision, and how your muscles are working. This helps them understand your current symptoms and brain function.
- Blood tests: Simple blood draws can tell us a lot. We'll check for infections, anemia, blood sugar levels (as these can sometimes mimic brain issues), cholesterol (which affects blood vessels), and how quickly your blood clots. We might also check for signs of a heart attack, as heart problems can sometimes lead to issues in the brain.
- Brain scans (imaging): These are like taking pictures of your brain and its blood vessels. This may include:
- CT scan: This is usually the first quick scan. It helps doctors see if there's bleeding in the brain or if a blockage is likely causing the problem.
- MRI scan: This scan provides even more detailed pictures of your brain tissue. It can show smaller or earlier changes that might not be visible on a CT.
- CT Angiography (CTA) or MR Angiography (MRA): These are special versions of CT or MRI that focus on the blood vessels themselves. They help us see if there are any narrow spots, blockages, or abnormal bulging in the vessels.
- Heart check (cardiac evaluation): Since heart problems can sometimes be the source of issues in the brain, your doctor might also check your heart using:
- EKG (electrocardiogram): This checks your heart's electrical activity to see if there are any irregular heartbeats.
- Echocardiogram (echo): This uses sound waves to create moving pictures of your heart, allowing doctors to see its structure and how it's pumping, and check for any potential clots inside.
- Heart monitor: Sometimes, a small portable monitor is worn for a day or longer to catch any irregular heart rhythms that come and go.
The combination of these tests allows your healthcare providers to pinpoint the cause and extent of cerebrovascular disease, guiding the most effective treatment plan.
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One in three Americans is — and may not even know it.
Types of cerebrovascular disease
The term cerebrovascular disease encompasses different types of strokes. It is the broad term for conditions and diseases that lead to not enough blood flow to the brain. The AHN Neuroscience multidisciplinary team treats cerebrovascular diseases including:
- Arteriovenous malformation: When abnormal blood vessels become tangled up in the brain. Learn more about arteriovenous malformation.
- Carotid artery stenosis: A narrowing of the large arteries on each side of the neck, often from a buildup of plaque inside the arteries, that can lead to a blockage or stroke. Learn more about carotid artery stenosis.
- Brain aneurysm: A bulge or swelling of a blood vessel in the brain that can leak or rupture, causing a hemorrhagic stroke. Learn more about brain aneurysms.
- Stroke: A stroke happens when the flow of blood to the brain is blocked or something causes bleeding in the brain, depriving the brain of oxygen.
- Transient ischemic attack (TIA): A TIA blocks blood from the brain for a short amount of time, but tends to resolve quickly. It is a strong warning sign of a future event.
Our medical team at AHN is here to provide compassionate, personalized care for these complex conditions. We're dedicated to guiding you through every step of your treatment journey.
Cerebrovascular disease treatment
Treatment for cerebrovascular disease often needs to happen swiftly and it is highly dependent on the specific type of condition (e.g., ischemic stroke, hemorrhagic stroke, TIA, aneurysm), the severity, and the underlying cause. The team at AHN is highly skilled and experienced in treating strokes.
During a stroke or TIA
Quick response and treatment is critical and may change based on the type of condition. Your AHN stroke care team will respond with a personalized treatment plan based on the type of stroke:
- For ischemic stroke (due to a clot): Time is critical. There are different procedures that can help, along with medication:
- Intravenous thrombolysis (IV t-PA or alteplase): A "clot-busting" drug given intravenously within a narrow time window (typically around 4 hours from symptom onset) to dissolve the clot and restore blood flow.
- Endovascular thrombectomy (mechanical thrombectomy): A procedure where a catheter is threaded through an artery (usually in the groin) to the brain to physically remove a large blood clot. This can be performed up to 6–24 hours after symptom onset in select patients with large vessel occlusions.
- Aspirin: May be given if mechanical thrombectomy is not indicated, or after thrombolysis if a patient has not already taken it.
- For hemorrhagic stroke (due to bleeding):
- Blood pressure control: Aggressive management of high blood pressure to prevent further bleeding and minimize brain damage.
- Reversal of anticoagulants: If the patient is on blood thinners, medications may be given to reverse their effects.
Surgery
AHN neurosurgeons are specially trained to help respond quickly during a stroke and may perform surgery. These surgical options may include:
- Clipping or coiling for aneurysms: If an aneurysm has ruptured, a neurosurgeon may perform open surgery to place a tiny clip at its base (clipping) or use endovascular techniques (coiling) to fill the aneurysm with platinum coils, preventing further bleeding.
- Craniotomy: To remove a hematoma (blood clot) that is causing significant pressure on the brain or to repair a bleeding vessel.
- AVM embolization or surgery: To close off the abnormal blood vessels in an AVM to prevent rupture.
- Carotid endarterectomy: Surgical procedure to remove plaque buildup from the carotid arteries in the neck. Recommended for significant carotid artery stenosis, especially in symptomatic patients.
- Carotid artery stenting: A less invasive procedure where a stent (a small mesh tube) is placed in the carotid artery to widen it and hold it open. Often used for patients who are not good candidates for endarterectomy.
Long-term management and prevention
After a cerebrovascular disease event, it is crucial to make lifestyle changes that can help reduce future strokes. These can include
- Taking medications: Your physician may prescribe you to take medications to lower blood coagulating, blood pressure, and cholesterol levels.
- Healthy diet: Low in saturated and trans fats, cholesterol, sodium, and refined sugars. Rich in fruits, vegetables, and whole grains.
- Regular exercise: At least 150 minutes of moderate-intensity exercise per week.
- Stop smoking: Crucial for improving vascular health.
- Moderate alcohol consumption: Limiting alcohol use is critical to a healthy lifestyle and reducing the risk of disease.
- Weight management: Achieving and maintaining a healthy weight.
Cerebrovascular disease FAQs
Cerebrovascular disease can cause significant and life-altering health effects. Knowing and understanding the various risk factors, health conditions, signs, and treatment options can help improve health outcomes. Your AHN care team is dedicated to your overall treatment and is available to help educate and communicate with you about cerebrovascular disease. Our patients often find that having trusted background information prior to their conversations with their team can help them feel more prepared and informed.
Can cerebrovascular disease be cured?
Cerebrovascular disease generally cannot be completely eliminated with no lasting effects, especially if damage to the brain has already occurred. However, it can be managed and treated to prevent further progression and minimize its impact. The approach to managing cerebrovascular disease focuses on:
- Preventing further damage: This is often the most critical aspect and involves addressing underlying risk factors like high blood pressure, high cholesterol, diabetes, and smoking.
- Treating acute events: For conditions like stroke, immediate medical intervention is crucial to limit brain damage.
- Rehabilitation: After a stroke or other cerebrovascular event, rehabilitation helps individuals regain lost functions and improve their quality of life.
What is the best treatment for cerebrovascular disease?
Cerebrovascular disease encompasses a range of conditions affecting blood flow to the brain, so the best treatment depends on the specific type of cerebrovascular disease, its severity, and the individual patient's health. Generally, the best treatment will revolve around modifying lifestyle habits that will reduce the atherosclerosis (hardening of the arteries from plaque buildup) that leads to stroke. These lifestyle adjustments can help treat cerebrovascular disease:
- Eating a healthy, balanced diet (e.g., DASH or Mediterranean diet)
- Getting regular physical activity
- Maintaining a healthy weight
- Quitting smoking
- Limiting alcohol consumption
- Managing stress
- Medications: If your doctor determines medicine is necessary, a variety of medications can be used to manage risk factors and prevent complications. These may include blood thinners, antiplatelet drugs, blood pressure medications, cholesterol-lowering medicines, and diabetes medication.
- Surgery or procedure: Your doctor may determine that surgery or a medical procedure is going to be the best option for you. If that is the case, they will discuss that with you so you feel confident in your care plan.
What is the main cause of cerebrovascular disease?
The main cause of cerebrovascular disease, in its broadest sense, is atherosclerosis. Atherosclerosis is a condition where plaque (deposits of cholesterol, fatty substances, cellular waste products, calcium, and fibrin) builds up inside your arteries. This plaque hardens and narrows your arteries, which limits the flow of oxygen-rich blood to organs and other parts of your body, including your brain
What are the risk factors for cerebrovascular disease?
The primary risk factors for cerebrovascular disease are largely modifiable and include high blood pressure, high cholesterol, and diabetes, which directly contribute to artery damage and plaque buildup (atherosclerosis). Smoking significantly increases this risk by harming blood vessels and promoting clot formation. Additionally, obesity, a sedentary lifestyle, and an unhealthy diet exacerbate these underlying conditions. Effectively managing these modifiable risk factors is crucial for prevention. Non-modifiable factors such as age and a family history of stroke or heart disease also play a role.
What are the complications of cerebrovascular disease?
Cerebrovascular disease can lead to a range of serious complications, primarily stemming from impaired blood flow to the brain. The most common and devastating complication is stroke, which occurs when a blood clot blocks an artery or a blood vessel ruptures, causing brain tissue damage. This can result in lasting neurological deficits such as paralysis, speech difficulties (aphasia), cognitive impairment, and problems with balance and coordination.
Beyond stroke, chronic issues like vascular dementia can develop due to repeated small strokes or persistent reduced blood flow, leading to progressive cognitive decline. Other potential complications include transient ischemic attacks (TIAs), serve as a warning sign for future strokes, and persistent headaches or seizures. The long-term impact of these complications can significantly reduce quality of life and independence.
How serious is cerebrovascular disease?
Cerebrovascular disease is very serious and can have life-altering or even fatal consequences. The seriousness stems from its direct impact on the brain, which controls virtually all bodily functions.
The potential for stroke, with its immediate and often debilitating effects like paralysis, speech loss, and cognitive deficits, makes it a critical medical concern. Furthermore, the risk of developing conditions like vascular dementia, which leads to progressive and irreversible cognitive decline, underscores its long-term severity.
Given these potential outcomes, early diagnosis and management are crucial to reducing the risks and improving patient outcomes.
Contact us
To schedule an appointment or learn more about the services at AHN Neuroscience, call 412-359-8850 in Pittsburgh or 814-452-7575 in Erie.