Bürger's disease or thromboangiitis obliterans (TAO) is a nonatherosclerotic segmental inflammatory obliterative vascular disease that affects medium- and small-sized arteries as well as superficial veins. Bürger's disease manifested in the brain has the following morphologic characteristics: arterial occlusions caused by thrombosis in small arteries without arteriosclerosis, and spatial predilection for the cerebral surface in the watershed region between the middle cerebral, anterior, and posterior cerebral arteries. TAO is characterized by claudication or ischemia of both legs and less so of the arms. The disease begins distally and progresses more proximally. The diagnosis of TAO requires the exclusion of an embolic source, autoimmune disease, diabetes, and hyperlipidemia. Arteriography should show the distal involvement with normal arterial lumen proximal to the popliteal or distal brachial level and the absence of atheromatous changes in the large vessels. Abstinence from tobacco will likely halt disease progression and sometimes result in regression of vascular changes.

Scleroderma (progressive systemic sclerosis) is a multisystem connective tissue disorder characterized by inflammation, fibrosis, and vasculopathy of affected tissues. CNS vasculitis, segmental vasospasm, and cerebrovascular calcifications may all play a role in causing strokes in patients with scleroderma. CNS vasculitis has been diagnosed in several patients with scleroderma and has been posited to cause strokes. Cerebral infarction in scleroderma patients in the absence of other plausible, causative factors should prompt an aggressive workup for vasculitis including angiography. Results of cerebral angiography in several patients thought to have vasculitis are consistent with the diagnosis of vasoconstriction. Arteriography revealed segmental, often smoothly contoured, narrowing of arteries of multiple sizes (small, medium, and large) in both the anterior and posterior circulations. Whether vascular calcium deposits were responsible for the patients' cerebrovascular symptoms is speculative. Scleroderma patients with cerebrovascular disease must take into consideration the potential causes of stroke.