Cerebral atherosclerosis

Cerebral atherosclerosis also called cerebral arteriosclerosis, is the result of thickening and hardening of the walls of the arteries in the brain. Symptoms of cerebral atherosclerosis include headache, facial pain, and impaired vision. Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow. The plaque can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis may be preventable and is treatable.

Cerebral atherosclerosis can cause serious health problems. If the walls of an artery are too thick, or a blood clot becomes caught in the narrow passage, blood flow to the brain can become blocked and cause an ischemic stroke. When the thickening and hardening is uneven, arterial walls can develop bulges (called aneurysms). If a bulge ruptures, bleeding in the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal.

Cerebral atherosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in the elderly, such as apathy, weeping, transient befuddlement, or irritability, might indicate that cerebral arteriosclerosis is present in the brain. Computer tomography (CT) and magnetic resonance imaging (MRI) of the brain can help reveal the presence of cerebral arteriosclerosis before ischemic strokes, hemorrhagic strokes, or vascular dementia develop.

Cerebral atherosclerosis causes

Atherosclerosis is a slow, progressive disease that may begin as early as childhood. Although the exact cause is unknown, atherosclerosis may start with damage or injury to the inner layer of an artery. The damage may be caused by:

• High blood pressure
• High cholesterol
• High triglycerides, a type of fat (lipid) in your blood
• Smoking and other sources of tobacco
• Insulin resistance, obesity or diabetes
• Inflammation from diseases, such as arthritis, lupus or infections, or inflammation of unknown cause

Once the inner wall of an artery is damaged, blood cells and other substances often clump at the injury site and build up in the inner lining of the artery.

Over time, fatty deposits (plaque) made of cholesterol and other cellular products also build up at the injury site and harden, narrowing your arteries. The organs and tissues connected to the blocked arteries then don’t receive enough blood to function properly.

Eventually, pieces of the fatty deposits may break off and enter your bloodstream.

In addition, the smooth lining of the plaque may rupture, spilling cholesterol and other substances into your bloodstream. This may cause a blood clot, which can block the blood flow to a specific part of your body, such as occurs when blocked blood flow to your heart causes a heart attack. A blood clot can also travel to other parts of your body, blocking flow to another organ.

Risk factors for cerebral arteriosclerosis

Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:

• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Smoking and other tobacco use
• A family history of early heart disease
• Lack of exercise
• An unhealthy diet.

Cerebral atherosclerosis prevention

The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:

• Quitting smoking
• Eating healthy foods
• Exercising regularly
• Maintaining a healthy weight

Just remember to make changes one step at a time, and keep in mind what lifestyle changes are manageable for you in the long run.

Cerebral atherosclerosis signs and symptoms

If you have atherosclerosis in the arteries leading to your brain, you may have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a stroke.

Cerebral atherosclerosis diagnosis

Images of your brain can pinpoint visible abnormalities caused by strokes, blood vessel diseases, tumors or trauma that may cause changes in thinking and reasoning. A brain-imaging study can help your doctor zero in on more likely causes for your symptoms and rule out other causes.

Brain-imaging procedures your doctor may recommend to help diagnose cerebral arteriosclerosis include:

• Computerized tomography (CT) scan. For a CT scan, you’ll lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create detailed cross-sectional images (slices) of your brain. A CT scan can provide information about your brain’s structure; tell whether any regions show shrinkage; and detect evidence of strokes, ministrokes (transient ischemic attacks), blood vessel changes or tumors. Sometimes you’ll receive an intravenous (IV) injection of a contrast agent that will help highlight certain brain tissues.
• Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into a tube-shaped MRI machine, which makes loud banging noises while it produces images. MRIs are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise. MRIs are generally the preferred imaging test because MRI can provide even more detail than CT scans about strokes, ministrokes and blood vessel abnormalities.
• Carotid ultrasound: This procedure uses high-frequency sound waves to determine whether your carotid arteries — which run up through either side of your neck to supply blood to the brain — show signs of narrowing as a result of plaque deposits or structural problems. Your test may include a Doppler ultrasound, which shows the movement of blood through your arteries in addition to structural features.

Cerebral arteriosclerosis treatment

Treatment for cerebral arteriosclerosis can include medications or surgery. Physicians also may recommend treatments to help people control high blood pressure, quit cigarette smoking, and reduce cholesterol levels, all of which are risk factors for cerebral arteriosclerosis.

Depending on your individual situation, your doctor may prescribe medications to:

• Lower your blood pressure
• Reduce your cholesterol level
• Prevent your blood from clotting and keep your arteries clear
• Help control your blood sugar if you have diabetes

Cerebral atherosclerosis prognosis

Cerebral arteriosclerosis can lead to life threatening health events such as ischemic or hemorrhagic strokes. People who survive stroke may have long-term neurological and motor impairments.