Cerebrovascular disease is the third leading

cause of death in developed countries after heart disease and cancer. The loss of these patients from the work force and the extended hospitalization they require during recovery make the economic impact of the disease one of the most devastating in medicine.

Cerebrovascular disease is caused by one of several pathophysiologic processes involving the blood vessels of the brain.

  • The process may be intrinsic to the vessel, as in atherosclerosis, lipohyalinosis, inflammation, amyloid deposition, arterial dissection, developmental malformation, aneurysmal dilation, or venous thrombosis.

  • The process may originate remotely, as occurs when an embolus from the heart or extracranial circulation lodges in an intracranial vessel

  • The process may result from inadequate cerebral blood flow due to decreased perfusion pressure or increased blood viscosity.

  • The process may result from rupture of a vessel in the subarachnoid space or intracerebral tissue.

The first three processes can lead to transient cerebral ischemia (transient cerebral ischemic attack or TIA) or permanent cerebral infarction (ischemic stroke), while the fourth results in either subarachnoid hemorrhage or an intracerebral hemorrhage (primary hemorrhagic stroke).

Haemorrhage is characterized by too much blood in a closed cranial cavity.

Thrombosis is characterized by loss of blood supply and a reduction in nutrient supply.