Brain Vascular Disease

Cerebrovascular (brain vascular) diseases account for about 158,000 deaths in the United States each year---most of them among people 65 and older. These brain vascular diseases include stroke, blockage of the blood vessels inside the brain; stenosis, narrowing of the arteries that supply blood to the brain; aneurysms, bulges in brain arteries; and cerebral hemorrhage, rupture of brain blood vessels. About 30,000 Americans each year have a ruptured cerebral aneurysm.

Stroke

• Stroke is the most common and lethal type of brain vascular disease. It is the third most common cause of death in the United States and a leading cause of long-term disability. In 2003, stroke cost about $51 billion in medical and disability expenses, according to the American Heart Association.

  About 500,000 of the 700,000 strokes Americans have each year are first-time events. One fourth of these stroke victims will experience another stroke within five years.

  Hardening of the arteries (atherosclerosis) sets the stage for blockage of arteries that feed the brain. Stroke occurs when there is a sudden or gradual cessation of blood flow to the brain that kills or damages brain cells. The resulting neurological damage can affect speech, memory, cognition, and movement.

  Brain atherosclerosis is responsible for about 40,000 strokes each year. The American Heart Association estimates there are 5.4 million stroke survivors in the U.S.

Signs, types of stroke

• Signs of stroke include nausea, dizziness, slurred speech, confusion and memory loss, severe headache, pronounced weakness or numbness on one side of the body, lost or blurred vision, noticeable loss of coordination or balance. If you experience any of these symptoms, call your doctor or go to the emergency room right away; earlier treatment can limit the damage caused by stroke.

  Ischemic stroke, the most common type, is caused when a clot blocks blood flow to the brain or a piece of plaque becomes dislodged from somewhere else in the body and travels to the brain, where it causes blood flow to cease.

  Hemorrhagic (bleeding) stroke can occur as a result of high blood pressure, aneurysm, by a blood vessel deformity and sometimes by anticoagulant medications.

  Transient ischemic attack is a temporary brain vascular episode that mimics symptoms of stroke. The cause of the blockage becomes dislodged before any permanent damage is done. But if you should experience such an attack, get emergency medical care.

Carotid stenosis

• When fat and cholesterol deposits build up in the carotid arteries that carry blood from the heart through the neck to the brain, the resulting narrowing of the arteries stenosis can lead to a transient ischemic attack or stroke. The condition is asymptomatic, but your physician may notice it when he/she listens with a stethoscope to your carotid arteries.

Vascular malformations

• Sometimes during pregnancy, malformation of the arteries that nourish the fetal brain can occur. The resulting mass of tangled abnormal and poorly-formed vessels is known as arteriovenous malformation. Most arteriovenous malformations are diagnosed through an MRI or by the mapping of blood vessels (angiography).

Risk factors

• To reduce your risk of brain vascular disease stop smoking, control high blood pressure, ask your physician to check your carotid arteries, control and manage your diabetes, ask your physician about your high blood cholesterol level, be physically active and reduce any amount of obesity or overweight. In addition, people who take hormone replacement therapy have an overall 29 percent increase in their risk of stroke.