Cerebrovascular Disease (Dr

Ischemia or hemorrhage are the byproducts of cerebrovascular disease, manifest as sudden, focal neurological deficits related to specific vascular territories of the central nervous system. Impairment or loss of consciousness is a global deficit, which rarely is caused by simultaneous, extensive or multiple hemorrhages or ischemic infarctions, and is more commonly due to other causes such as cerebral hypoperfusion, vasovagal syncope, or toximetabolic disorders. Some focal neurological deficits occur transiently from migraine or after seizures, and may mimic cerebrovascular disease (rarely migraine-related ischemic infarctions do occur). Cerebrovascular disease follows cancer and cardiovascular disease as a common cause of disability and death in the United States. Transient ischemic attacks (TIAs) are defined as sudden, focal neurological deficits which completely resolve within 24 hours. Years of experience have shown that most TIAs only last minutes, but are a serious warning of high stroke risk. Stroke refers to a sudden, focal neurological deficit which does not completely resolve within 24 hours, but may variably improve over several weeks to months. Most of the time, a stroke is caused by ischemic infarction. Immediate medical attention is required for both TIAs and stroke, in order to prevent complications, limit neurological deficits if possible, and prevent future strokes. Appropriate therapy will vary and depends on the mechanism of the TIA or stroke and the localization of the vascular territory affected.