Cerebrovascular disease

Cerebrovascular diseases are conditions caused by problems with the blood vessels that supply the brain.

Cerebrovascular disease is also a type of cardiovascular disease that affects the brain's blood vessels.

Types of cerebrovascular disease

There are a number of different types of cerebrovascular disease. The four most common types are:

• stroke - a serious medical condition where the blood supply to the brain is interrupted 
• transient ischaemic attack (TIA) - a temporary fall in the brain's blood supply, 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 - problems with the blood circulation, leading to parts of the brain not receiving enough blood and oxygen

These are discussed in more detail below.

Stroke

To function properly, the brain needs oxygen and nutrients that are provided by the blood. However, if the blood supply is restricted or stopped, brain cells die, leading to brain damage and possibly death.

A stroke happens when the brain's blood supply is blocked or interrupted - for example, by a blood clot (where the blood thickens and solidifies). This is the most common cause of stroke.

The main symptoms of a stroke can be remembered using the acronym FAST, which stands for Face-Arms-Speech-Time. Each symptom is explained below.

• Face - the person's face may have fallen on one side, they may be unable to smile, or their mouth or eye may have drooped
• Arms - they may be unable to raise both arms and keep them there due to weakness or numbness
• Speech - they may have slurred speech
• Time - it's time to dial 999 immediately if you see any of these signs or symptoms

A stroke is a medical emergency. The sooner treatment is received, the less damage is likely to occur.

Transient ischaemic attack (TIA)

A transient ischaemic attack (TIA) or "mini-stroke" is caused by temporary disruption in the blood supply to part of the brain. This results in a lack of oxygen to the brain.

A TIA can cause similar symptoms to a stroke, although they tend to only last for a short period of time (less than 24 hours).

However, a TIA should be taken seriously because it's an early warning sign of further TIAs or a stroke. 

If you or someone you know has had a TIA, you should contact your GP, local hospital or out-of-hours service immediately to arrange for a specialist assessment.

Subarachnoid haemorrhage

A subarachnoid haemorrhage is a less common cause of stroke. It happens when blood leaks from blood vessels onto the surface of the brain.

The bleeding occurs in the arteries that run underneath a membrane in the brain known as the arachnoid, which is located just below the surface of the skull.

A subarachnoid haemorrhage is a medical emergency and needs immediate medical treatment to prevent serious complications, brain damage and death.

Around three quarters of all subarachnoid haemorrhages are the result of an aneurysm rupturing (bursting). An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall.

Other causes of a subarachnoid haemorrhage include severe head injury and a rare type of birth defect that affects normal blood vessel formation called arteriovenous malformations.

Vascular dementia

Vascular dementia is a common form of dementia that affects more than 138,000 people in the UK.

The term "dementia" describes a loss of mental ability associated with the gradual death of brain cells.

It's caused by reduced blood flow to the brain as a result of a problem with the blood vessels that supply it. Parts of the brain become damaged and eventually die from a lack of oxygen and nutrients.

Children

Cerebrovascular diseases are much less common in children. However, stroke can sometimes affect children.

The Stroke Association estimate that childhood stroke affects around five out of every 100,000 children in the UK each year.

Abnormalities in the brain's blood vessels, resulting in bleeding in the brain, are the leading cause of childhood stroke. The classic warning signs of a stroke are the same in adults and children (see above).

Children may also experience additional symptoms including:

• a high temperature (fever) of 38ºC (100.4ºF) or above
• fits (seizures)
• nausea and vomiting
• vision loss 

Dial 999 immediately to request an ambulance if you think your child has had a stroke.