What You Should Know About Cerebrovascular Disease

Cerebrovascular disease is a disease of the blood vessels in the brain, especially the arteries, and it is one of the leading stroke risk factors.

Arteries in the brain deliver blood that supplies vital nutrients and oxygen to the brain tissue. The blood vessels in the brain are susceptible to damage caused by a number of factors, including:

• Hypertension or intermittent high blood pressure
• High cholesterol
• Diabetes
• Hereditary blood vessel disease 
• Smoking

How Cerebrovascular Disease Develops

The medical conditions that are listed above cause recurrent inflammation and injuries to the inner lining of the blood vessels. Cerebrovascular disease develops over time through this gradual damage.

Injury to the inner lining of blood vessels causes them to become narrow, stiff and sometimes irregularly shaped. Often, unhealthy blood vessels are described as having atherosclerosis, a stiffening of the inner lining, usually associated with cholesterol build up.

How It Causes a Stroke

When blood vessels develop cerebrovascular disease, they become prone to blood clots. A blood clot may start forming within an artery when the artery is narrow or disfigured on the inside.

When a blood clot grows inside a blood vessel it is called a thrombus. A thrombus that dislodges and travels through the blood vessel circuitry to another location in the body is called an embolus. A thrombus or an embolus can get stuck in the narrow blood vessels in the brain. When that happens, the damaged blood vessels from the cerebrovascular disease cause an interruption of blood supply called ischemia.

Irregularities and abnormalities due to cerebrovascular disease also cause the blood vessels to become more likely to tear, increasing the risk of hemorrhage, which is bleeding. When hemorrhage occurs, brain tissue damage from bleeding as well as brain tissue damage from ischemia both occur simultaneously.

When cerebrovascular disease develops, often there is also cardiovascular disease and vascular disease present throughout the body and as well. The causes of cerebrovascular disease are similar to the causes of diseases of other blood vessels. Some people are more prone to vascular disease in some blood vessels than other blood vessels.

There are some genetic conditions that cause cerebrovascular disease out of proportion to vascular disease in other parts of the body.

Consequences

The presence of extensive cerebrovascular disease can cause small silent strokes over time. Because the brain often has the capacity to compensate for some damage, many people suffer from small strokes and do not experience symptoms because healthy areas in the brain compensate by doing double duty.

Connection Between Cerebrovascular Disease and Dementia

Cerebrovascular disease can contribute to symptoms of dementia. Some people with extensive cerebrovascular disease do not exhibit the stereotypical symptoms typically associated with strokes, such as weakness, speech difficulty or vision loss, but have dementia instead. This is caused by the brain’s difficulty in integrating thoughts and memories as a result of the cumulative damage caused by many small strokes over time.

How to Know If You Have It

Often, people who have had many silent strokes due to cerebrovascular disease are surprised when they are told that their brain MRI or brain CT scan shows evidence of previous strokes. This incidental finding suggests that there have been silent areas of infarction that did not cause obvious symptoms.

Over time, if several small silent strokes occur, a critical threshold may be reached. At this point, symptoms may suddenly become apparent if the compensatory ability of the brain is overwhelmed.

There is not usually a routine screening test for cerebrovascular disease, but it can sometimes be detected with brain imaging studies. The absence of obvious cerebrovascular disease on a brain CT or MRI does not mean that it is not present.

Treatment

Fortunately, with today's availability of medication, despite the narrowing of the cerebral arteries, stroke risk can be decreased by using a treatment regimen that may include antiplatelet agents and statins.

A Word From Verywell

The idea of cerebrovascular disease may be somewhat alarming—but it should not be. If you have been diagnosed with cerebrovascular disease, there are effective ways to prevent it from worsening.

Controlling the risk factors that cause the development of cerebrovascular disease is the best way to reverse it and to prevent it from getting worse. Most cerebrovascular disease can be at least partially improved by lowering cholesterol, controlling blood pressure and diabetes, and quitting smoking. This may require prescription medications or lifestyle changes, such as exercise and healthy eating, but the benefit of preventing a stroke is well worth it.