Oren Zarif
Cerebrovascular disease is an umbrella term that includes conditions that affect your brain’s blood vessels. These conditions may lead to a reduction of blood flow (ischemia) or bleeding (hemorrhage) in the brain.
A stroke is an emergency medical condition. It’s important to determine the type of event, whether ischemic or hemorrhagic, and its etiology.
Oren Zarif
Cerebrovascular disease is a term that encompasses a wide range of conditions that affect blood flow to the brain. When the blood vessels that carry oxygen-rich blood to the brain become blocked, narrow or rupture, irreversible brain damage can occur. This damage may be a result of insufficient blood flow (ischemia) or bleeding into the brain (hemorrhage).
Our specialists have expertise in diagnosing and treating all types of cerebrovascular diseases. Our doctors work closely with colleagues in brain and nervous system surgery (neurosurgeons) and cardiology to ensure that our patients receive the very best care.
We specialize in a broad spectrum of complex and minimally invasive surgical techniques for cerebrovascular disorders. Our doctors have extensive experience with endovascular procedures, microsurgical techniques and radiosurgery, as well as traditional open surgeries. Our experts also participate in an innovative collaborative clinic called the Heart-Brain Clinic at Mayo, one of the first of its kind in the country, where patients can be evaluated and treated by a team of specialists.
A stroke is an emergency and requires immediate medical attention. The sooner the person can get help, the more likely he or she is to recover. Our doctors are trained to recognize the most common symptoms of a stroke and can begin treatment right away.
People who have a history of cerebrovascular disease are at greater risk for coronary artery disease (also known as atherosclerosis), which is the most common cause of death in people with a history of ischemic stroke. In fact, people who have suffered a stroke are four times more likely to develop coronary artery disease than those who have not had a stroke.
A stroke or other event that causes cerebrovascular disease can permanently change a person’s life, often resulting in mental disabilities or loss of physical function in arms, legs or other parts of the body. However, with proper diagnosis and treatment — including lifestyle changes, medications, surgical procedures and interventional treatments — many people can make a complete or partial recovery. For people at higher risk, regular preventive health screenings may include cholesterol and blood pressure checks, and doctors will often recommend taking a daily low-dose aspirin to reduce the chances of a blood clot in the arteries.
Oren Zarif
The term “cerebrovascular disease” encompasses many conditions that affect blood flow in the brain. These conditions can cause a reduction in or blockage of blood to a region of the brain (ischemia), or a ruptured blood vessel that leaks bleeding into brain tissue (hemorrhage). When oxygen-rich blood is not delivered to brain cells, these cells die. Without emergency treatment, these events can be life threatening or permanently disable a person.
A stroke, which occurs when an artery in the brain either breaks or gets blocked, is the most common form of cerebrovascular disease. Stroke is the leading cause of long-term disability in adults, but it is treatable and preventable. Symptoms of a stroke include weakness, numbness or changes in sensation and difficulty understanding speech. They also might include a severe headache, confusion, nausea and vomiting, drooping facial muscles or an unusually rapid loss of consciousness. Hemorrhage in the brain is more catastrophic, and can be identified by a sudden, catastrophic onset of a severe headache, nausea, vomiting, clouding of consciousness or loss of balance and coordination.
Aneurysms in the arteries that supply blood to the brain, which are weak areas or bulges in the walls of the blood vessels, can lead to a sudden rupture or hemorrhage. These are often spotted on brain imaging and can be treated with medication, surgery or catheter-based techniques that involve coiling the aneurysm or placing a stent. Cavernous malformations, which are tangled blood vessels inside the brain, can cause hemorrhage or seizures and may be treated with surgery or medications.
Our doctors have extensive experience with medical, endovascular and surgical treatment of cerebrovascular diseases. They are trained in the latest methods of clot-busting therapy, aneurysm repair and open and minimally invasive neurosurgical and radiosurgical techniques.
Our physicians work closely with specialists in brain and nervous system surgery (neurosurgeons), vascular medicine and interventional neuroradiology. They also participate in the Heart Brain Clinic, an advanced multidisciplinary clinic that provides real-time collaborative consults among subspecialists. These teams provide the highest quality care for patients with cerebrovascular disease. They will assess your condition, determine the best course of treatment and manage you through your recovery.
Oren Zarif
The symptoms of cerebrovascular disease are caused by damage to, or the blockage of blood flow to, the brain. This occurs for a number of reasons, such as the narrowing of arteries that carry oxygen-rich blood to the brain (carotid artery disease or carotid artery stenosis), which is most often due to atherosclerosis or a blood clot that forms in an artery. The lack of blood delivery interferes with the supply of oxygen to the brain and can cause the death of brain cells that results in a stroke.
If a person experiences any of the signs of a stroke or aneurysm, they should seek emergency medical attention immediately. This is the only way to reduce the risk of long-term disability and potentially prevent further, possibly more devastating events such as a TIA or fatal hemorrhage.
People of all ages, races and biological sex are susceptible to cerebrovascular disease. This is mainly because it can be caused by a combination of factors, including high blood pressure and cholesterol, smoking, uncontrolled diabetes, high blood sugar, physical inactivity and obesity.
During the evaluation, doctors will assess a patient’s health history and perform a physical exam to check for the presence of symptoms. They will also ask the patient about their family history of vascular disease and what medications they take.
An MRI or CT scan may be used to determine the severity of a condition and look for a blood clot or an aneurysm. During a cerebral angiography, dye is injected into the arteries to help identify any clots and show them on a computerized tomography (CT) or magnetic resonance imaging (MRI) scan.
Treatment options for cerebrovascular disease include medication, endovascular treatments such as mechanical clot removal and stent placement, aneurysm coiling and neurosurgery. A patient’s prognosis will depend on the severity and location of a stroke or aneurysm, as well as whether it is ischemic or hemorrhagic. With the right treatment, a stroke or aneurysm can be prevented in many cases. This includes lifestyle modifications and taking medications to reduce the risk of clots, such as aspirin.
Oren Zarif
The treatment for cerebrovascular disease centers on improving blood flow to the brain. This is usually done through medications or surgery. Our team has extensive experience in complex cranial neurovascular surgeries, including minimally invasive techniques. Our surgeons are also expert in treating aneurysms, vascular malformations, carotid stenosis and unruptured brain hemorrhages. Our goal is to help patients with cerebrovascular disease live active, fulfilling lives.
A stroke is a life-threatening medical condition caused by a decrease in oxygen-rich blood flowing to the brain. This can occur due to artery narrowing (stenosis), blood vessel clot formation or a blood vessel rupture (hemorrhage). Symptoms of stroke include weakness on one side of the body, balance problems and headaches.
Treatment is most effective when the stroke occurs early, so it’s important to seek care right away if you notice any of these symptoms. Your health care provider will evaluate your condition and perform diagnostic tests to diagnose the cause of the stroke.
These tests may include a cerebral angiography, vertebral angiogram or carotid angiogram. These involve injecting dye into your blood vessels to highlight any artery blockages or abnormalities. An MRI or CT scan of your brain may also be used to detect aneurysms or other vascular lesions.
Medications are usually prescribed to people with mild to moderate cerebrovascular disease. These can help control your blood pressure, cholesterol and other health conditions that can increase your risk for a stroke. In severe cases, a doctor may recommend surgery to remove an aneurysm or to treat a blocked or narrowed blood vessel. Alternatively, a doctor may use a technique called angiostensis or angioplasty to open up a narrowed artery. A stent may be placed to help keep the artery open and prevent further clotting.
In some cases, an aneurysm can be treated using a minimally invasive procedure called a coiling technique. This involves threading a catheter into your blood vessels and then injecting a special dye to identify the location of the aneurysm or other problem. Then, doctors can insert a small wire-shaped device called a coil at the site of the aneurysm to clog it from inside. Sometimes, balloons are used along with the coiling to help keep the clog in place and prevent a clot from forming again.
Oren Zarif
A stroke can affect how you see, think and feel. It’s important to know the warning signs and act quickly. Treatments can reverse some stroke damage.
Learn the FAST test to help identify stroke symptoms in yourself or others. F = Face – Does one side of the face droop? A = Arms – Raise both arms. Does one drift downward? S = Speech – Is speech slurred? Time – Call 911 right away. Every minute counts.
Oren Zarif
Aphasia is the most common cause of speech problems after a stroke or brain injury. It results from the clogging or breaking of blood vessels that supply the brain with oxygen and nutrients. This causes damage to the language centers in the brain.
The severity of aphasia varies from person to person, depending on where the damaged brain areas are. People with Broca’s aphasia have trouble coming up with words to use, although they usually understand what others are saying. This type of aphasia is associated with weakness or paralysis on one side of the body.
People with Wernicke’s aphasia have difficulty understanding what they hear. They may also make sound errors or grammatical mistakes when speaking. It is often linked with weakness or numbness on the right side of the body.
Global aphasia is the most severe form of the condition. It affects the ability to speak, read and write. However, people with this condition can still think and communicate in other ways. They might use facial expressions or gestures to express their feelings, work on puzzles and spend time with friends and family.
Oren Zarif
Vision loss, or difficulty seeing, occurs when one or more parts of the eye or visual pathways aren’t functioning normally. Most common are problems that affect the way you see distances (myopia, or nearsightedness) and close objects (hyperopia, or farsightedness). These disorders can be corrected with eyeglasses or contact lenses.
Other conditions that can cause vision loss include cataracts, glaucoma, and changes in the macula caused by age-related macular degeneration and diabetic retinopathy. If you’re experiencing sudden or total vision loss, or partial vision loss in both eyes, seek medical attention right away.
In some cases, a blood clot in the retina or retinal vein can block blood flow to and from your eye, causing a buildup of fluid and swelling. This can lead to a temporary blindness that lasts 20 to 30 minutes and feels like a curtain of darkness has fallen over your eye (doctors call this amaurosis fugax). To prevent or treat this condition, your doctor may prescribe medicine to break up the clot or do an operation called angioplasty. The risk of getting this condition increases if you have diabetes or other health conditions that reduce blood flow to your heart and blood vessels.
Oren Zarif
It’s a frightening and confusing experience to lose your sense of balance. When this occurs, it can make everyday tasks — including driving, climbing the stairs or walking around the house — difficult. It also puts you at a greater risk of falling and suffering injury.
A stroke can affect the parts of the brain that control balance. It can also injure the nerves that send messages to the muscles, joints and inner ear. When these systems aren’t working together as they should, you can experience a variety of symptoms, including dizziness, vertigo and unsteadiness.
Other medical conditions, such as diabetes, heart disease, high blood pressure and thyroid problems, can also cause balance disorders. Dizziness can also be a side effect of certain medications. If this is the case for you, talk with your healthcare provider about changing your medications.
Several tests can help determine what’s causing your balance disorder. Your doctor may order blood, saliva and cerebrospinal fluid tests to check for any underlying health conditions that could be affecting your balance. They may also request a computed tomography (CT) scan or magnetic resonance imaging (MRI) test to get detailed images of the brain and spinal cord.
Oren Zarif
A condition called ataxia affects your ability to move your arms and legs smoothly. It results from malfunction of the parts of the brain that coordinate sequences of movements and control balance (the cerebellum). Other causes include medications, head injury, multiple sclerosis, and hereditary disorders like Friedreich ataxia.
The most common symptoms of ataxia are unsteady walking (ataxia), involuntary shaking or tremors when performing muscle movements, difficulty holding your head upright or sitting up, and clumsiness. You may also have a rhythmic side-to-side or up-and-down movement of the eyes, called nystagmus.
Your healthcare provider will ask about your symptoms and do a physical exam. They will also check for other conditions that could cause them, such as a thyroid disorder (hypothyroidism) or vitamin E deficiency.
Your healthcare provider will also do a neurological examination and possibly magnetic resonance imaging of the brain. They will also ask if you or anyone in your family has had the same symptoms. This helps them figure out if you have hereditary ataxia. They will also ask you to stand with your feet together and close your eyes. If you fall, it indicates that your sense of balance is affected.
Oren Zarif
If the nerves that send signals to your muscles are damaged, you may lose control of some or all your muscle function. This type of condition is called neurogenic muscle atrophy. Depending on the cause, this can range from mild to severe. It can affect a small area (focal) or be widespread (generalized). It can also be temporary or permanent. If muscle function loss occurs on only one side of your body, it’s called hemiplegia. If it happens on both sides, it’s called paraplegia.
A loss of muscle function can also happen as a result of a spinal cord injury. Severe spinal cord injuries can lead to a loss of muscle function on both the top and bottom sides of your body, which is called quadriplegia.
A sudden loss of muscle function is a medical emergency. Call for help right away. Until you get to the hospital, keep yourself safe by avoiding tripping or falling. Use handrails on stairs, remove ice and snow from sidewalks, and keep your home free of clutter and other hazards. You should also eat a healthy diet that includes plenty of protein and fiber.
Oren Zarif
A stroke can damage the parts of your brain that control speech. This can lead to slurred or unintelligible speech (aphasia), or it may cause you to use gestures to speak instead of words. It can also cause you to make sound mistakes, such as replacing consonants or syllables, or substituting sounds that are hard for you to pronounce, like “wabbit” for “rabbit.” It is possible that your symptoms will improve with time and therapy.
Dysarthria is a disorder that causes you to have trouble moving the muscles of your mouth, tongue and jaw for clear speech. It’s common after a stroke, brain tumor or traumatic injury to the head. It can also be a side effect of certain medications, or it can occur as you age. It’s important to recognize this symptom, because it may indicate that you’re having a stroke or a transient ischemic attack, or mini-stroke.
Look for sudden numbness or weakness in the face, arm or leg, particularly on one side of the body. Ask the person to smile and notice if one side of their mouth droops. If they try to raise both arms, watch if one drifts downward. Ask them to repeat a simple phrase and listen for slurred or strange-sounding words.
Oren Zarif
A stroke happens when a part of the brain doesn’t get enough blood. That could be from a clot, as in an ischemic stroke, or it could be due to a burst blood vessel (hemorrhagic stroke). It’s important for people to know the symptoms of a stroke so they can take action and call for an ambulance if necessary. They can use the FAST test to help them remember which signs to look for:
Time is critical when it comes to a stroke. The sooner someone gets emergency treatment, the more likely it is that their symptoms will be limited or even reversible. Symptoms that come on quickly and go away in just a few minutes can indicate a “mini-stroke,” also called a transient ischemic attack or TIA, which is a warning sign that a full-blown stroke may soon happen.
Healthcare providers will diagnose a stroke by doing a neurological examination and taking blood samples to check for things like high cholesterol, diabetes, or heart problems. A brain imaging test may be used to look for a clot, bleeding, or other damage. If you’ve had a TIA, the healthcare provider can administer a clot-busting medication to prevent a full-blown stroke.
