Cerebrovascular Disease

Information for patients and carers

What does the term ‘Cerebrovascular Disease’ mean?

The term ‘Cerebrovascular Disease’ is used to describe problems in the circulation of the blood to the brain (cerebrovascular disease). When this causes significant problems in memory, thinking or behaviour the terms “Dementia in Cerebrovascular Disease”, “Vascular Dementia”, or “Multi Infarct Dementia” might be used. Cerebrovascular Disease is the second most common cause of dementia after Alzheimer’s Disease.

What are the symptoms of Cerebrovascular Disease?

There is quite a lot of variability in the symptoms people experience as a result of cerebrovascular disease. People may experience forgetfulness, confusion, or difficulty carrying out activities that require planning and organisation.  People with Cerebrovascular Disease may also find it difficult to follow conversations and may have some difficulty expressing themselves. People with Cerebrovascular Disease may feel physically weaker or become unsteady on their feet.

Some individuals with Cerebrovascular Disease become depressed.  They can also experience mood swings, with laughter and tears occurring for no apparent reason.

Sometimes, strokes may cause damage to specific parts of the brain.  This may result in more specific difficulties in reading, writing, speaking, or other skills.

The differences in the types of symptoms people experience are due to difference in the areas of their brain which blood is not able to supply.

Will symptoms become worse?

Symptoms do tend to get worse over time, as the underlying problems with blood supply cause damage to more of the brain. In Cerebrovascular Disease, the progress of symptoms often progress in a ‘step-wise’ way. People may notice that their symptoms can be stable for a time and the get worse suddenly but then are stable again. The symptoms tend to progress in these steps. However, 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 common in men than in women.

What is the cause?

The brain has a complex structure of blood vessels, which supply different areas with the oxygen and nutrients they need to function properly. When these blood vessels aren’t able to supply these nutrients properly because they become blocked, the brain tissue can be damaged.  When this happens over a large area of the brain it is called a stroke. In Cerebrovascular Disease, these blockages may be so small that they aren’t noticed at the time. However, they can often be seen on brain scans.

There is often no clear single reason that somebody might develop Cerebrovascular Disease but there are many factors which interact to increase the risk of problems with the blood supply to the brain. These are called Vascular Risk Factors.

What are vascular risk factors?

People who suffer from strokes or Cerebrovascular Disease have often experienced other health problems in their life which make problems with blood supply more likely. 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 of cerebrovascular disease are extremely rare. However, some families seem to be more prone to vascular risk factors than others. This is thought to be due to complex interactions between their genetic makeup and the environment, rather than a specific gene being a cause.

Is there any treatment?

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

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 dementias. If you would like to find out more about the research carried out in our unit, please ask when you attend the clinic.