Diagnosis, classification and principles of management of cerebrovascular atherosclerotic disease from perspective of angiology

Czech version

Authors: P. Gavorník ^{1 3}; A. Dukát ^{1 3}; Ľ. Gašpar ^{1 3}; L. Slezáková ^1,3; N. Hučková ^1,3; K. Kusendová ^{1 3}; G. Gubo ^1,2; X. Faktorová ^1,2; E. Cikatricisová ^1,2; P. Sabaka ^1,3
Authors‘ workplace: II. interná klinika LF UK a UN Bratislava ¹; Prvé angiologické pracovisko II. internej kliniky LF UK a UN Bratislava ²; Angiologická sekcia Slovenskej lekárskej komory ³
Published in: Kardiol Rev Int Med 2015, 17(4): 354-361
Category: Cardiology Review

Overview

Aim:
The aim of this review is to look at internal and angiological studies of cerebrovascular arterial disease in order to assess their contribution to our expanding knowledge of organovascular arterial diseases and of atherosclerosis.

Discussion:
The National Institute of Neurological Disorders and Stroke (NINDS) is a part of the U.S. National Institute of Health (NIH). It conducts and funds research on disorders of the brain and nervous system. NINDS defines cerebral arteriosclerosis as the result of thickening and hardening of the walls of brain arteries, which can cause serious health problems. If an arterial wall becomes critically thick, or a blood clot is caught in a stenosis, blood flow to the brain can be reduced or blocked as a result of this stenosing‑ obliterating vascular process, leading to ischaemic stroke. When the thickening and hardening is uneven, arterial walls can develop aneurysms. If a bulge ruptures, bleeding in the brain can cause haemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom‑free strokes cause cumulative damage and death to neurons (nerve cells) in the brain, potentially manifested by apathy, depression, disorientation, aggressiveness, etc. Computer tomography (CT) and magnetic resonance imaging (MRI) of the brain can help reveal the presence of cerebral arteriosclerosis before ischaemic strokes, haemorrhagic strokes, or vascular dementia develop.

Conclusion:
Organovascular arterial ischaemic diseases are important manifestations of systemic atherosclerosis and other arterial diseases of the vascular system. Key clinical‑ etiology‑ anatomy‑ pathophysiology (CEAP) diagnostic aspects and management principles of cerebrovascular arterial ischaemic diseases are discussed in this review (project Vessels).

Keywords:
angiology/vascular medicine – arteriology – organovascular arterial ischaemic diseases – cerebrovascular diseases – CEAP diagnosis – management

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