Published: 18 Jun 2025

ICD9: 437.0      ICD10: I67.2      ICD11: BD55

Cerebrovascular disease (CVD) due to atherosclerosis (also often referred to as arteriosclerosis, although technically they are slightly different) is a condition where blood vessels supplying the brain become narrowed or blocked by plaque buildup.
Let's break that down:

Cerebrovascular: This term refers to the blood vessels (arteries and veins) within the brain and related structures. 'Cerebro' means brain, and 'vascular' means relating to blood vessels.

Atherosclerosis (often used synonymously with Arteriosclerosis):
Atherosclerosis: This is the specific process where plaque builds up inside the arteries. Plaque is made of cholesterol, fats, calcium, and other substances found in the blood. Over time, this plaque hardens and narrows the arteries.
Arteriosclerosis: This is a more general term that means "hardening of the arteries." Atherosclerosis is the *most common* type of arteriosclerosis. The distinction is sometimes blurred in everyday usage, and the terms are often used interchangeably.

How it works:

1. Damage to Arterial Walls: The inner lining of the arteries can be damaged by various factors, including high blood pressure, high cholesterol, smoking, diabetes, and inflammation.

2. Plaque Formation: When the arterial wall is damaged, cholesterol and other substances start to accumulate at the site of injury. This forms plaque.

3. Artery Narrowing (Stenosis): As the plaque grows, it narrows the artery, reducing blood flow to the brain.

4. Thrombosis or Embolism: The plaque can rupture, causing a blood clot (thrombus) to form on its surface. This clot can further block the artery at that location (thrombosis) or break off and travel through the bloodstream to block a smaller artery downstream in the brain (embolism).

Consequences of Reduced Blood Flow:

The reduced blood flow to the brain caused by narrowed or blocked arteries can lead to various problems, including:

Transient Ischemic Attack (TIA): A "mini-stroke" caused by a temporary interruption of blood flow to the brain. Symptoms are similar to a stroke but resolve within a short period (usually less than 24 hours). TIAs are a warning sign of a higher risk of a future stroke.

Stroke: Occurs when blood flow to an area of the brain is completely blocked or severely reduced. Brain cells die due to lack of oxygen and nutrients. This can result in:
Weakness or paralysis on one side of the body
Difficulty speaking or understanding speech
Vision problems
Loss of coordination
Numbness or tingling
Headache
Seizures

Vascular Dementia: A decline in cognitive function (thinking, memory, and reasoning) caused by reduced blood flow to the brain over time due to multiple small strokes or chronic reduced blood flow.

Risk Factors:

Risk factors for atherosclerosis and subsequent cerebrovascular disease include:

High blood pressure (hypertension)
High cholesterol (hyperlipidemia)
Smoking
Diabetes
Obesity
Family history of heart disease or stroke
Age
Lack of physical activity
Unhealthy diet
Chronic inflammation

Diagnosis:

Diagnosis usually involves:

Physical Exam and Medical History: To assess symptoms and risk factors.
Neurological Exam: To evaluate brain function.
Imaging Tests:
CT scan or MRI: To visualize the brain and identify areas of damage.
Carotid ultrasound: To assess blood flow in the carotid arteries in the neck.
Cerebral angiography (CTA or MRA): To visualize the blood vessels in the brain and identify blockages or narrowing.

Treatment:

Treatment aims to:

Reduce Risk Factors: Lifestyle changes such as:
Quitting smoking
Eating a healthy diet (low in saturated and trans fats, cholesterol, and sodium)
Regular exercise
Maintaining a healthy weight
Managing stress

Medications:
Antiplatelet medications (e.g., aspirin, clopidogrel): To prevent blood clots.
Statins: To lower cholesterol.
Antihypertensive medications: To lower blood pressure.
Medications to control blood sugar (for diabetics):

Surgical or Interventional Procedures:
Carotid endarterectomy: Surgical removal of plaque from the carotid artery.
Carotid angioplasty and stenting: A balloon catheter is used to widen the narrowed artery, and a stent is placed to keep it open.
Thrombectomy: Removal of a blood clot blocking an artery (often done in acute stroke).

Prevention:

Preventing atherosclerosis and CVD is crucial and involves managing the risk factors listed above. A healthy lifestyle is key.

In summary, cerebrovascular disease due to atherosclerosis is a serious condition that can lead to stroke, TIA, and vascular dementia. Early diagnosis and treatment, along with lifestyle modifications to reduce risk factors, are important to prevent complications. Always consult with a healthcare professional for diagnosis and treatment options.