Cerebrovascular Diseases: Symptoms, causes, diagnosis and treatment

Diseases related to our blood vessels are known as vascular diseases. Cerebrovascular disease is also vascular disease associated with the cerebrum of the brain. This disease hinders the supply of blood to the brain leading to the shortage of oxygen in the brain resulting in stroke. Cerebrum part of the brain is responsible for the control heart beating and other higher functions of the brain such as thought and action. 

Some common types of cerebrovascular diseases

• Cerebral Embolism- It occurs when blood flow to the brain is blocked due the presence of air, plaque or a clot.  
• Cerebral Thrombosis- It is a blood clot that appears in the blood supply to brain.
• Cerebral Hemorrhage- It is a type of stroke causing internal bleeding and damage to the brain cells.
• Aneurysm- It is a disease leading to the swelling in the artery, which occurs in the brain, back of the knee or intestine.  

Symptoms of cerebrovascular diseases

• The symptoms of cerebrovascular disease are dependent on the location of the person’s embolism, hemorrhage or thrombus and the level to which the cerebral tissue has been destroyed.
• Patient may not be able to cough properly and loses his gag reflex. 
• Difficulty in swallowing, poor hand-eye coordination, speech impairment.   
• Vomiting
• Dizziness
• Fever
• Sudden Weakness
• Loss of balance
• Paralysis and Coma

Causes of cerebrovascular diseases

• Stroke occurs when a blood vessel that transports blood to the brain is jammed due to plaque or a blood clot which causes brain cells to die leading to stroke. 
• On the other hand, it is possible, a clot may have formed in some other part of the body and travelled to brain and blocked the artery through which the blood is transported to brain.
• Some lifestyle diseases that are major risk factors of stroke include diabetes, hypertension and obesity.

Diagnosis of Cerebrovascular diseases

The treatment of cerebrovascular diseases is conditioned upon the natures of individual disease. There may be different types of strokes and due to various reasons, before the treatment is necessary to know the problem associated with particular patients. 

• A doctor often diagnoses a stroke using a stethoscope, noticing abnormal sounds of blood flow or a through physical examination of patient is done.
• MRI-Magnetic Resource Imaging or MRI is the scan done for detecting strokes. MRI examines your blood vessels using magnetic and radio frequency waves to generate a comprehensive view of organs and system inside your body.
• CAT Scan- Computerized axial tomography is a painless procedure done to identify the origin of hemorrhagic strokes and shows the bleeding in the brain and damaged cells due to stroke. 

Treatment of Cerebrovascular diseases

• The treatment for cerebrovascular diseases comprises of medication and changes in the lifestyle of the patient. 
• The emergency treatment of cerebrovascular diseases involves injecting medicine into the brain or discarding clot with surgery.
• Surgery is done for the treatment of aneurysm, hemorrhage, thrombosis embolism and occlusive vascular diseases so that oxygen and nutrients can be delivered to brain without any obstruction.

World Brain Tumour Day: Major Breakthroughs in treating brain tumour

Despite significant advances in cancer research and treatment, one form of cancer - brain tumours - remain particularly feared, and for good reason. Because of their location, brain tumours can severely impact an individual's personality, memories and basic motor skills, robbing the patient of their very being. The impact on family and friends is felt greatly, as their loved one may be "lost" to them even earlier than feared. While there are more than 120 types of brain tumours, for the most common and serious adult tumours, Glioblastoma multiforme (GBM), the chances of living 5 years is less than 3%. Most patients will live no more than a year or two despite aggressive therapy.

However, few maladies manage to both simultaneously confound researchers in their mystery, yet hold such promise for the cure and management as prominently as brain tumours. There is strong belief that some significant breakthroughs in brain tumour treatment may only be 4-6 years away. Complementing traditional chemotherapeutic and surgical approaches, four emerging breakthroughs are discussed here which are rapidly transforming the treatment of brain tumours and related conditions.

Gene Therapy

Gene therapy approaches involve the insertion of genes into growing brain tumours, rendering them more sensitive to some chemotherapeutic agents that are relatively non-toxic to the rest of the body. Some promising experiments have demonstrated that with insertion of genes into animal brain tumour cells and administration of chemotherapy, complete destruction of the tumour may be possible without spread of the tumour. Other approaches in gene therapy include substitution of abnormal genes for normal genes, the repair of abnormal genes via selective reverse mutation, and gene regulation (i.e., altering the instructions within a gene to "turn on or off").

Vaccines

One area showing substantial promise in brain tumour treatment is based on an immunotherapeutic approach; that is, using a patient's immune system as an instrument for cancer therapy. This approach is premised on a body's immune response toward cells bearing tumour markers or antigens. One major focus area has been "active immunotherapy", described as the administration of the tumour antigenic material to help "vaccinate" a patient against their own tumour. Other vaccine approaches, including dendritic cell-based vaccines, Cytokine immunogene therapy, Bacterial and viral tumour vaccines, and GBM-specific molecular pathway vaccines are also being considered. The vaccine approach holds challenges that need to be evaluated against other treatment options that may require crucial patient choices, but they are continuing to emerge as an area of significant promise.

Stereotactic Radiosurgery/Radiotherapy

There is growing usage of stereotactic radiosurgery and radiotherapy among neurosurgeons. The tools, used for the non-invasive treatment of tumours and other brain, head, spine and neck conditions, use sophisticated mechanical systems and image-guided technology to treat tumours, using high, targeted doses of radiation (in a single session) to attack the tumour and minimising contact with healthy tissue. The image guidance systems direct the radiation to the tumour; some systems shape the radiation beam to map to the exact shape of the tumour, and software can help direct the ideal access points to the tumour.

Dual Agent Drug Therapies

Some of the field's leading researchers have concluded that traditional treatment for many brain tumours has started with a faulty premise; namely, that interventions for brain tumours were simply a palliative effort designed to decrease patient discomfort and increase stabilisation. The conclusion is that while these therapies have shown some success on their own, when multiple therapeutic agents are combined, (an approach more commonly used with cancers not as fatal) an increasing number of brain tumour patients are seeing increases in survival. Also, newer drugs are showing the ability to block the growth of tumours by attempting to interfere with their proteins that control tumour growth. And other, specialised treatment regimens are being formulated for patients whose tumours are shown to grow at an accelerated rate compared with typical tumours.

These are but four of the upcoming approaches where we may continue to see major breakthroughs in treatment or management of brain tumours. The hope in all these courses is that ultimately, brain tumours may in some cases be curable or at least achieve status as a manageable disease, as with many other serious and chronic conditions such as diabetes.