Cerebrovascular diseases (CBVD) are conditions that develop as a result of problems with the blood vessels inside the brain. Many people, as they get older, develop some cerebrovascular disease but this is mainly without symptoms and does not affect their lives. Some forms of cerebrovascular disease are more serious and need urgent treatment.
Types of CBVD
The most common types of symptomatic CBVD are:
- stroke - a medical condition where the blood supply to the brain is interrupted
- transient ischaemic attack (TIA)- a temporary fall in the blood supply to the brain, resulting in a lack of oxygen to the brain
- subarachnoid haemorrhage- an uncommon cause of stroke where blood leaks out of the brain's blood vessels
- vascular dementia - blood circulation problems result in parts of the brain not receiving enough blood and oxygen
The four types of CBVD are discussed in more detail below.
A stroke is a serious medical condition that occurs when the blood supply to the brain is disturbed or interrupted.
In order to function properly, the brain - like all organs - needs oxygen and nutrients that are provided by the blood. However, if the blood supply is restricted or stopped, brain cells will begin to die. This can lead to brain damage and possibly death.
An ischaemic stroke occurs when the blood supply to the brain is blocked as a result of a blood clot (where blood thickens and becomes solid). This is the most common cause of a stroke.
The main symptoms of a stroke can be remembered with the word FAST, which stands for Face-Arms-Speech-Time. Each of the symptoms is explained below.
- Face - the face may have fallen on one side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms - the person who has had a suspected stroke may not be able to raise both arms and keep them there due to arm weakness or numbness.
- Speech - they may have slurred speech.
- Time - it's time to dial 112 immediately if you see any of these signs or symptoms.
A stroke is a medical emergency. Prompt treatment is essential because the sooner a person receives treatment, the less damage is likely to occur.
A subarachnoid haemorrhage is a less common cause of stroke. It occurs when blood leaks from blood vessels onto the surface of the brain.
Like all strokes, a subarachnoid haemorrhage is a medical emergency that requires immediate treatment to prevent serious complications, brain damage and death.
Three quarters of all subarachnoid haemorrhages are the result of an aneurysm rupturing (bursting). An aneurysm is a bulge in a blood vessel that's caused by a weakness in the blood vessel wall.
Other causes of a subarachnoid haemorrhage include:
- severe head injury
- arteriovenous malformations - an uncommon type of birth defect that affects the normal formation of blood vessels
Transient ischaemic attack (TIA)
A transient ischaemic attack (TIA) or 'mini-stroke' is caused by a temporary fall in the blood supply to part of the brain, which results in a lack of oxygen to the brain.
This can cause symptoms that are similar to a stroke, although they don't last as long (stroke symptoms usually persist until treatment is provided). The symptoms of a TIA tend to last for a few minutes only.
However, having a TIA should be taken seriously because it's an early warning sign. There's around a one-in-five chance that people who have a TIA will experience a full stroke during the four weeks that follow the TIA.
If you or someone you know has had a TIA, contact your GP, local hospital or out-of-hours service immediately to arrange for a specialist assessment.
Dementia causes a range of related symptoms that are associated with an ongoing decline of the brain and its abilities. These include:
Vascular dementia is the second most common type of dementia after Alzheimer's disease. It's caused by brain damage that results from:
- a stroke
- a TIA
- a silent brain infarction - a type of mild stroke that doesn't cause any noticeable symptoms but still results in brain damage
Public health impact
CBVD is a leading cause of death in Ireland. It's estimated that 1 in every 10 deaths is due to a CBVD, usually a stroke.
In 2008 in Ireland, there were just over 2,000 deaths as a result of CBVD. Advancing age is an important risk factor for CBVD, but there's an increasing trend for these types of conditions to develop in middle aged adults.
For example, of the deaths resulting from CBVD in 2008 (mentioned above), almost 100 occurred in people who were under 55 years old.
Conditions that occur as a result of problems that develop with blood vessels in the brain are also the leading cause of long-term disability in Ireland
Cerebrovascular disease and stroke in children
Cerebrovascular diseases are much less common in children than they are in adults. However, stroke can affect children sometimes.
It's estimated that stroke is among the top 10 causes of childhood death.
The leading cause of childhood stroke is abnormalities in the blood vessels of the brain that cause bleeding in the brain. The classic warning signs of a stroke are the same in adults and children. See the 'FAST' set of symptoms, which are mentioned on this page.
Children may also experience additional symptoms including:
- a high temperature (fever) of 38ºC (100.4ºF) or above
- fits (seizures)
- nausea (feeling sick)
- vomiting (being sick)
- vision loss
Dial 112 immediately to request an ambulance if you think that your child has had a stroke.
An aneurysm is a blood-filled sac that forms in a weakened part of a blood vessel.
Arteries are blood vessels that carry blood from the heart to the rest of the body.
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.
The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
Cholesterol is a fatty substance made by the body that lives in blood and tissue. It is used to make bile acid, hormones and vitamin D.
An embolism is the sudden blockage of a blood vessel, usually by a blood clot or air bubble.
A rupture is a break or tear in an organ or tissue.
Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.