| ID | 114 |
|---|---|
| Name | CEREBROVASCULAR DISEASE (CVD) |
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| Introduction | Cerebral vascular diseases are one of the most common causes of death and . disability of the population in the developed and developing world. Cerebral vascular diseases usually lead to cerebral, ischaemia or infarction from occlusion of the blood vessels (15-20%) or haemorrhage through their rupture (•80-85%). This disease commonly presents as an ‘acute focal stroke’ characterised by the sudden appearance of a focal neurological deficit most commonly a hemiplegia with or without signs of focal higher cerebral dysfunction, hemisensory loss, visual field defect op2brain-stem deficit Vascular disorder causing stroke: Cerebral atherosclerosis, arteriolar sclerosis, embolism, arteritis, arterial dissection, vasospasm etc. Risk factors for vascular disease & stroke: Hypertension, IHD, Diabetes mellitus, Peripheral vascular disease, Cardiomyopathy, Polycythaemia, Contraceptive pill. Other, factors like smoking, obesity, hyperlipidaemia and physical inactivity. |
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| Types | Types of Cerebrovascular disease:2 1. Cerebral insufficiency or ischaemia- due to transient disturbance of blood flow or rarely to hypertensive encephalopathy. 2. Cerebral infarction- due to either embolism or thrombosis of the intra and/or extracranial arteries. 3. Cerebral haemorrhage- which includes intracerebral and subarachnoid haemorrhage. Clinical presentation of acute focal stroke:2 1. Transient stroke: This is almost always due to cerebral ischaemia, and hence also termed as ‘transient ischaemic attack (TIA)’. In this deficit recovers within 24 hours. 2. Completed stroke: Acute focal stroke when presenting persistent focal deficit, but not worsening. 85% due to cerebral infarction, the remainder due to cerebral haemorrhage. 3. Evolving .stroke: When focal deficit continues to worsen after about 6 hours from onset. This is often due to progressive occlusion of a cerebral artery. |
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