Cerebral atherosclerosis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 6, 2016
StartDiseasesCerebral atherosclerosis

Cerebral arteriosclerosis is a condition that often occurs when the walls of the arteries in the brain swell and harden. Impaired vision, headache, and pain in the face are some of the symptoms of cerebral arteriosclerosis. Arteriosclerosis is also known as hardening of the arteries. Cerebral atherosclerosis is the narrowing of the cerebral arteries as a result of the accumulation of fatty plaques.

Contents

Definition & Facts

Atherosclerosis is the accumulation of plaque on the walls of arteries. The accumulation causes blood vessels to narrow and harden, obstructing blood flow to the brain, in the case of cerebral atherosclerosis.

Blood clots may lead to the development of an ischemic stroke. The walls of the arteries can develop bulges known as aneurysms when the arterial walls harden and thicken. A person can suffer a hemorrhagic stroke if an aneurysm ruptures. Neuroimaging scans such as magnetic resonance imaging (MRI) and computed tomography (CT) can help diagnose cerebral arteriosclerosis.

According to the American Heart Association, cerebral atherosclerosis usually progresses slowly. Smoking, high blood sugar (hyperglycemia), high cholesterol levels in the body, and high levels of triglycerides (hypertriglyceridemia) may trigger cerebral atherosclerosis.

Cerebral arteriosclerosis is related to vascular dementia which can result from silent strokes and transient ischemic attacks (also known as mini-strokes). The presence of cerebral arteriosclerosis in the elderly is often characterized by personality changes including irritability, apathy, and weeping.

Symptoms & Complaints

When there is limited supply of blood to the brain, a patient can suffer stroke and experience the following symptoms:

Causes

Atherosclerosis can begin in a patient at a young age as fatty streaks in their blood vessels. The patient can then develop plaques and lesions in their cerebral arteries which narrow as a result.

An embolism can occur which blocks the blood vessel in its entirety. An atheroma which is the fatty plaque that damages blood vessels can also cause vascular occlusion in which the blood vessels are blocked.

Certain factors including high levels of sugar in the blood, high blood pressure (hypertension), smoking and high cholesterol levels can destroy the inner walls of the artery and trigger atherosclerosis. People with diabetes mellitus are more likely to acquire atherosclerosis due to high blood glucose levels.

Damaged areas of an artery are likely to have plaque accumulation, which can rupture open with time. Blood cell fragments, also known as platelets or thrombocytes, accumulate at the affected area when the plaque raptures. Platelets and plaque fragments can stick on to each other and form lumps.

Genetic factors also play a major role in the development of atherosclerosis. People whose parents have/had cardiovascular diseases and atherosclerosis are more likely to develop this condition, indicating that family history is an important factor. Exposure to environmental toxicants may also lead to progression of atherosclerosis. In 2007, researchers from the University of California found evidence of increased risk of bad cholesterol buildup in the arteries due to exposure to diesel exhaust particles in the air.

Diagnosis & Tests

A full patient medical history, family history, and physical examination may be conducted. Computer tomography and magnetic resonance imaging can help diagnose cerebral arteriosclerosis before hemorrhage or stroke occurs. In addition, an angiogram can help diagnose plaque accumulation in the arteries. Angiogram results of patients with cerebral arteriosclerosis may show a normal-looking luminal diameter, but with a marked contraction of the affected area. Since angiograms need X-rays to be seen, the number of procedures patients can undergo in a year is restricted due to the risk of radiation exposure.

Magnetic resonance imaging (MRI) can also be carried out to determine the plaque anatomy and structure. The test also helps doctors to establish various features of the plaque including its likelihood to rupture. The number of times an MRI test is performed a patient is not a concern since it doesn’t use ionizing radiation. However, patients with metallic implants cannot use MRI.

Multidirectional computed tomography (MDCT) is a better choice for diagnosing cerebral arteriosclerosis. It provides fast and more reliable diagnosis than CT scans. In addition, MDCT offers an advanced spatial resolution. Multidirectional computed tomography utilizes X-rays to provide an image of the arterial thickening or hardening. It can also be used to identify the plaque’s structure. Inherent risks can also be determined using MDCT. Use of this procedure is limited because it exposes patients to significant amounts of radiation.

Treatment & Therapy

To successfully treat cerebral atherosclerosis, a doctor has to target the factors that caused it. Better management of diabetes, blood cholesterol levels, and high blood pressure can minimize the development of cerebral atherosclerosis. However, there are other treatments approaches including lifestyle changes that can prevent cerebral atherosclerosis before it even develops.

Patients with intracranial stenosis are often advised to take platelet inhibitors such as aspirin. Anti-coagulation medication may also be prescribed to help prevent the development of cerebral arteriosclerosis. Anticoagulant medication can also help reduce the chances of further plaque buildup in the arteries. 

Prevention & Prophylaxis

Preventing cerebral atherosclerosis will help keep away many related health conditions. Lifestyle changes can help minimize complications associated with peripheral vascular diseases, plaque formation on arterial walls, and heart disease, which consequently help to prevent the development of cerebral arteriosclerosis.

Regular exercise and avoiding alcohol consumption and quitting cigarette smoking can help prevent cerebral arteriosclerosis. Staying away from unhealthy foods with high saturated fat content is another lifestyle change that can help prevent cerebral arteriosclerosis. High blood pressure, obesity, and diabetes are often associated with cerebral arteriosclerosis. Managing these conditions can help minimize the chances of developing cerebral arteriosclerosis.