Cerebrovascular diseases are conditions affecting the blood vessels of the brain, leading to impaired blood flow and potential brain damage. Common examples include stroke, transient ischemic attack, aneurysm, and vascular malformations.
Ischemic stroke occurs when a clot blocks blood flow to brain tissue, causing cell death. Rapid diagnosis and treatment with clot-dissolving drugs or mechanical thrombectomy are essential to minimize neurological deficits and improve recovery outcomes.
Hemorrhagic stroke develops due to ruptured vessels within the brain. Causes include uncontrolled hypertension, aneurysm rupture, or vascular malformations. Management involves controlling bleeding, reducing intracranial pressure, and stabilizing vital functions.
Preventive measures for cerebrovascular diseases include blood pressure control, cholesterol management, smoking cessation, and lifestyle modifications. Regular screening and medical monitoring significantly reduce the risk of serious brain vascular events.
Prof. Dr. Özgür KILIÇKESMEZ Prof. Dr. Kılıçkesmez holds the Turkish Radiology Competency Certificate, the Turkish Interventional Radiology Competency Certificate, Stroke Treatment Certification, and the European Board of Interventional Radiology (EBIR). In his academic career, he won the Siemens Radiology First Prize in 2008.
Interventional Radiology / Interventional Neuroradiology
What Are the Symptoms of Cerebrovascular Diseases?
The symptoms of cerebrovascular diseases usually have a significant impact on an individual’s daily life. One of the most common symptoms is sudden loss of strength; this usually occurs on one side of the body, especially with numbness in the face, arm, or leg. This may cause drooping in the facial muscles or difficulty in raising an arm. Secondly, speech and language problems are common. Individuals may experience sudden speech impairment or difficulty understanding language, leading to slurred speech and inability to form coherent sentences.
Vision problems usually include the following:
- Sudden vision loss
- Double vision
These symptoms result from problems in the vessels supplying the visual pathways. Individuals may also experience severe headaches. These headaches are often described as the worst in their lives and may be accompanied by neck stiffness, nausea, or vomiting. Dizziness and loss of balance are also common symptoms of cerebrovascular diseases. This may lead to difficulty walking or loss of coordination. The risk of seizures increases, especially when brain damage is severe.
How Do Cerebrovascular Diseases Cause Stroke?
Stroke is one of the most serious outcomes of cerebrovascular diseases. It is characterized by interruption of blood flow to brain cells. There are two main types: ischemic and hemorrhagic stroke.
Ischemic stroke occurs when the brain’s blood vessels are blocked. The most common causes are:
- Atherosclerosis: Fatty deposits form on the inner surface of arteries. These deposits can narrow the vessels or break off to form a thrombus that blocks blood flow.
- Embolism: A clot formed in the heart or elsewhere in the body travels to the brain and gets lodged in a cerebral artery.
- Hemorrhagic stroke occurs when blood vessels in the brain rupture. The main causes are:
- Hypertension: High blood pressure can weaken brain vessels and cause ruptures.
- Aneurysms and Arteriovenous Malformations: Structural weaknesses in vessel walls can lead to rupture and bleeding.
In both cases, the interruption of blood flow leads to the death of brain cells and serious damage. In ischemic stroke, metabolic disturbances occur due to lack of oxygen. In hemorrhagic stroke, the pressure caused by bleeding damages brain tissue. *We recommend filling out all fields so we can respond in the best possible way.
What Are the Risk Factors for Cerebrovascular Diseases?
The risk factors for cerebrovascular diseases include a variety of complex elements. The risk increases with age, especially for those over 55. Men are generally more affected than women, although this difference decreases with age. Genetic predisposition also increases the likelihood of these diseases, especially for those with a family history of stroke or cardiovascular disease.
Certain ethnic backgrounds are at higher risk; for example, African Americans and Hispanics may be more affected than Caucasians due to a combination of genetic and environmental factors. Many risk factors are also related to personal lifestyle choices, including:
- Hypertension: High blood pressure causes vessel damage and increases the risk of stroke.
- Diabetes: Elevated blood sugar has adverse effects on vascular health.
- Smoking: Nicotine and other chemicals trigger hardening of the arteries.
- Hyperlipidemia: High LDL and low HDL levels cause plaque formation in vessels.
- Obesity: Especially excess weight concentrated in the abdominal area triggers other risk factors for stroke.
- Sedentary lifestyle: Lack of physical activity contributes to cardiovascular health problems.
- Diets high in salt, saturated fats, and trans fats: These nutrients impair vascular health and increase risk.
- Excessive alcohol consumption: High amounts of alcohol can lead to hypertension and heart rhythm disorders.
How Are Cerebrovascular Diseases Treated?
Treatment methods for cerebrovascular diseases are highly diverse and are tailored to specific situations. In acute ischemic stroke, if there is a large vessel clot and the patient reaches the hospital within the first 6 hours, endovascular thrombectomy is preferred. In this procedure, stent retrievers or aspiration catheters are used to mechanically remove the blood clot from the cerebral arteries. Timing of the procedure is critical to the success of the treatment. Intracranial stenting is used to open narrowed or blocked arteries. This technique keeps the vessels open and reduces the risk of stroke.
Endovascular techniques used in the treatment of brain aneurysms include:
- Coiling
- Stent-assisted treatments
Both methods are designed to safely treat aneurysms. Coiling fills the aneurysm to trigger clotting and minimize the risk of rupture. Flow diverters promote healing by diverting blood flow away from the aneurysm.
Embolization procedures are used for arteriovenous malformations and aneurysms. In this method, adhesives or coils are used to block abnormal vessels, significantly reducing the risk of bleeding. Intra-arterial thrombolysis is also effective, especially in stroke treatment. Thrombolytic drugs are delivered directly to the clot via a catheter, often in combination with mechanical thrombectomy. Balloon angioplasty is used to widen narrowed arteries, usually followed by stent placement. This restores blood flow and improves vessel functionality.
What Are the Symptoms of a Cerebrovascular Aneurysm?
Among cerebrovascular diseases, aneurysm can cause particularly serious health problems. The symptoms of unruptured and ruptured aneurysms differ. Unruptured aneurysms are often asymptomatic and are usually discovered incidentally during imaging for other reasons. However, in some cases, they can cause symptoms by pressing on brain tissue or nerves. These symptoms include:
- Localized headaches, especially focused above and behind the eyes.
- Vision problems, which may appear as double vision or vision loss.
- Numbness or weakness in the face, usually affecting one side.
- Seizures may occur as the aneurysm presses on brain tissue.
The symptoms of ruptured aneurysm are more severe and sudden. These include:
- Sudden and severe headache, often described as the worst headache of one’s life.
- Nausea and vomiting accompany the severe headache.
- Neck stiffness caused by pressure of bleeding on the meninges.
- Sensitivity to light and loss of consciousness, sometimes seen as brief fainting.
- Seizures may develop after rupture.
- Neurological deficits such as paralysis or speech difficulties may occur.
What Are the Long-Term Effects of Cerebrovascular Diseases?
The long-term effects of cerebrovascular diseases are varied and can significantly impact patients’ quality of life. After severe events such as stroke, individuals often experience various physical and cognitive impairments. This can severely limit their daily activities and sense of independence.
Physical disabilities generally include:
- Motor deficits such as hemiparesis
- Coordination and balance problems
- Speech and swallowing difficulties such as dysarthria and dysphagia
Cognitive decline can affect patients’ memory and attention skills. This can range from mild cognitive impairment to more serious conditions such as vascular dementia. This decline in cognitive function poses additional challenges for both patients and caregivers.
Psychological effects are also common. Depression and anxiety can develop due to the trauma experienced as well as physical and cognitive limitations. These conditions can lead to social isolation and an overall decrease in quality of life.
Neurological sequelae may increase the risk of recurrent stroke and cause chronic pain syndromes, which often originate from damage to the central nervous system.
Cardiovascular complications increase the risk of serious conditions such as myocardial infarction and heart failure in stroke survivors.
Epigenetic and immune system changes may contribute to persistent inflammation and cause vascular damage to spread to other organs. This increases the risk of systemic complications and makes the treatment and recovery process more complex.
Interventional Radiology and Neuroradiology Speaclist Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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