25 - Occlusive cerebrovascular disease

Summary

This chapter describes the diagnosis, treatment, and prognosis for occlusive cerebrovascular disease: ischaemic stroke and cerebral venous thrombosis. Stroke is the third leading cause of death after myocardial infarction and cancer, and the leading cause of permanent disability and of disability-adjusted loss of independent life years in western countries. There are several imaging modalities that can be used to identify patients who may benefit from acute recanalization therapy after ischaemic stroke. Carotid endarterectomy (CEA) is the treatment of choice for symptomatic carotid stenosis, with several studies confirming its efficacy in the secondary prevention of ischaemic stroke. To preserve the long-term benefits of CEA, arterial blood pressure and other cerebrovascular risk factors such as hyperlipidaemia and diabetes mellitus should be monitored and treated as appropriate. There are multiple causes of non-infectious CVT including coagulation disorders, trauma and malignancies.