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Cerebrovascular Disease

Information for patients and carers

Introduction
Cerebrovascular Disease is the second most common cause of cognitive impairment after Alzheimer's Disease.

What does the term 'Cerebrovascular Disease' mean?
The term 'Cerebrovascular Disease' is used to describe cognitive problems that are associated with problems in the circulation of the blood to the brain (cerebrovascular disease).  The term ‘Multi Infarct Dementia’ is sometimes used to refer to this condition. 

What are the symptoms of Cerebrovascular Disease?
Sufferers may feel physically weakened and become unsteady on their feet. The mental changes can include forgetfulness, confusion, and difficulty carrying out activities that require planning and organisation.  Individuals with Cerebrovascular Disease may also find it difficult to follow conversations and may have some difficulty expressing themselves. 

Some individuals with Cerebrovascular Disease become depressed.  Sufferers can also experience mood swings, with laughter and tears occurring for no apparent reason.
 
Sometimes, strokes may cause damage to parts of the cortex as well as to the white matter.  This type of vascular insult may result in more specific difficulties in reading, writing, or speaking.

Will symptoms become worse?
Symptoms do tend to worsen over time. In Cerebrovascular Disease, symptoms are sometimes said to progress in a ‘step-wise’ fashion: the person’s abilities deteriorate suddenly and then stabilise for a while and then deteriorate again. However, very often the steps are so small that the decline appears smooth and gradual.

At what age are people affected?
Cerebrovascular disease becomes more common as people get older, and is a common disorder of the elderly.  However, it can occur in younger people, affecting some people in middle age. It is slightly more prevalent in men than in women.

What is the cause?
The brain is irrigated by a complex structure of blood vessels, which supply different areas of the brain with the oxygen and nutrients they need to function properly. When a blood vessel in the brain bursts or is obstructed by a clot, the brain tissue normally supplied with oxygen by this blood vessel deteriorates.  This is often called a stroke. In Cerebrovascular Disease, these strokes may be so small that no one may have noticed their occurrence. However, they can be detected on brain scans.

What are vascular risk factors?
People who suffer from strokes have often experienced other health problems in their life. These are called vascular risk factors because if a person has experienced one of these it increases the risk of them having a stroke or developing Cerebrovascular Disease. The most common risk factor is high blood pressure. Other risk factors include diabetes, a high cholesterol level, heart disease, smoking and a high level of alcohol consumption.

Is Cerebrovascular disease inherited?
No, not typically. Inherited cases are cerebrovascular disease are extremely rare.

Is there any treatment?
Although there is currently no treatment to reverse the damage that has already occurred, treatment to prevent additional strokes is very important. Medicines can be prescribed to control high blood pressure, high cholesterol, heart disease or diabetes. A healthy diet, exercise and avoidance of smoking and excessive alcohol intake can also help to lessen the risk of further strokes.  Your doctor may recommend aspirin, as this can help thin the blood and prevent further damage.

Is there research into the condition?
Yes, certainly. The interest in this area of research increases each year. The aim is to understand the mechanisms that underlie this disorder, so that better treatments can be developed. Our department is an active contributor to research in cerebrovascular disease and other degenerative disorders. If you would like to find out more about the research carried out in our unit, please visit our website or ask when you attend the clinic.