Overview of cerebrovascular disease
Cerebrovascular disease is a general term for brain diseases caused by various causes of vascular lesions or blood flow disorders in the brain. The classification and pathogenesis of cerebrovascular diseases are diverse, and familiarity with their etiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis are essential for the prevention and treatment of cerebrovascular diseases.
Cerebrovascular disease can be divided into two types: acute cerebrovascular disease and chronic cerebrovascular disease according to the form of its onset. Chronic cerebrovascular disease refers to brain metabolic disorders and functional decline due to chronic inadequate blood supply, with insidious symptoms and slow progression. Cerebral arteriosclerosis and cerebrovascular dementia belong to chronic cerebrovascular disease. Acute cerebrovascular disease, also known as stroke, is a syndrome of limited or generalized neurological deficits with an acute onset and duration of at least 24 hours due to acute local cerebral blood circulation disorders. Stroke can cause focal signs and symptoms consistent with the area of blood supply to the affected cerebral vessels; when there is diffuse cerebrovascular dysfunction, such as whole brain ischemia due to cardiac arrest, it is not considered a stroke.
Classification of cerebrovascular diseases
The classification scheme of cerebrovascular diseases is the standard for clinical diagnosis, treatment and prevention of diseases, and different classification methods have long been proposed according to different perspectives.
(1) Transient ischemic attack, progressive stroke and complete stroke can be classified according to the course of the disease;
The former includes cerebral thrombosis, cerebral embolism and lacunar infarction, while the latter includes cerebral hemorrhage and subarachnoid hemorrhage. 1995, the 4th National Academic Conference on Cerebrovascular Diseases classified cerebrovascular diseases in China as follows.
1.Transient ischemic attack Carotid artery system; vertebrobasilar artery system.
2.Stroke
(1) Subarachnoid hemorrhage: ruptured aneurysm; vascular malformation; abnormal intracranial vascular network disease; other; cause unknown.
(2) Cerebral hemorrhage: hypertensive cerebral hemorrhage; cerebrovascular malformation or aneurysm hemorrhage; hemorrhage secondary to infarction; tumor hemorrhage; hematologic hemorrhage; amyloid cerebrovascular disease hemorrhage; arterial inflammatory hemorrhage; pharmacologic hemorrhage; other; cause unknown.
(3) Cerebral infarction: atherosclerotic thrombotic cerebral infarction; cerebral embolism; lacunar infarction; hemorrhagic infarction; asymptomatic infarction; others; cause unknown.
3.Inadequate blood supply of vertebrobasilar artery.
4.Cerebrovascular dementia.
5.Hypertensive encephalopathy.
6.Intracranial aneurysm: cystic aneurysm; atherosclerotic aneurysm; infected aneurysm; traumatic aneurysm; others.
7.Intracranial vascular malformation: cerebral arteriovenous malformation; cavernous hemangioma; venous vascular malformation; capillary dilation; cerebral-facial hemangiomatosis; Galen’s vein aneurysm-like malformation; intracranial-extracranial vascular traffic arteriovenous malformation; others.
8, cerebral arteritis: infectious arteritis; aortitis (aortic arch syndrome); systemic lupus erythematosus; nodular polyarteritis; temporal arteritis; occlusive thrombotic vasculitis; others.
9, other arterial diseases: cerebral artery steal syndrome; intracranial anomalous vascular network disease; arterial myofibrillar dysplasia; amyloid angiopathy; entrapment aneurysm; others.
10, intracranial venous disease, venous sinus and cerebral venous thrombosis: cavernous sinus thrombosis; superior sagittal sinus thrombosis; lateral sinus (transverse sinus, sigmoid sinus) thrombosis; straight sinus thrombosis; others.
11, extracranial segment venous disease: carotid artery, vertebral artery stenosis or occlusion; carotid artery twist; carotid artery, vertebral artery aneurysm; other.