Classification of cerebrovascular diseases
1. Big picture
Cerebrovascular diseases are disorders of the brain caused by abnormal blood supply or abnormal bleeding from cerebral vessels. In exam language, the central idea is simple:
Sudden focal neurological deficit = vascular disease until proven otherwise.
The first and most important classification is:
| Main group | Meaning | Key examples |
|---|---|---|
| Ischemic cerebrovascular disease | Reduced blood flow causes brain ischemia or infarction | Transient ischemic attack, ischemic stroke, lacunar infarct |
| Hemorrhagic cerebrovascular disease | Vessel rupture causes bleeding into or around the brain | Intracerebral hemorrhage, subarachnoid hemorrhage |
| Venous cerebrovascular disease | Impaired venous drainage causes raised intracranial pressure, venous infarction or hemorrhage | Cerebral venous sinus thrombosis |
For the final exam, the most important practical point is that ischemic and hemorrhagic stroke cannot be reliably distinguished clinically. Both may present with acute hemiparesis, aphasia, visual field defect, brainstem signs, or impaired consciousness. Therefore, urgent brain imaging is mandatory, usually non-contrast computed tomography (CT) first.
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