Many cerebrovascular diseases, sometimes referred to as neurovascular diseases, need lifelong management. Diagnosing and treating these complex conditions requires deep knowledge and experience.
The cerebrovascular disease experts at Penn Medicine provide complete care for diseases that affect the blood vessels in your brain and spine. Whether your cerebrovascular disease management is brief or ongoing, we value our relationship with you and work diligently to protect your health with expertise that translates to a level of care you won’t find elsewhere in the region.
What Is Cerebrovascular Disease?
Cerebrovascular disease refers to a range of conditions that affect the blood vessels (vascular system) in the brain and spinal cord. The vascular system in your brain is an elaborate network of arteries and veins. Arteries carry oxygen-rich blood from your heart to your organs and tissues. Veins carry blood back to your heart.
Problems that arise in the blood vessels can damage the brain and spinal cord. These problems usually occur due to:
- Blockage (embolism)
- Clot formation (thrombosis)
- Narrowing (stenosis)
- Rupture (hemorrhage)
Cerebrovascular conditions have a wide range of causes. You can have them at birth or develop them over time. In general, the causes of cerebrovascular disease include genetic change during pregnancy, inherited conditions, poor lifestyle choices, physical trauma, and individual characteristics that are out of your control, such as age, race, and gender.
Signs and Symptoms of Cerebrovascular Dysfunction
Many people with cerebrovascular disease do not have any symptoms. A stroke may be the first sign. In some cases, doctors discover cerebrovascular diseases during imaging tests they order for other reasons.
The most common cerebrovascular symptoms are headaches and seizures. Other symptoms include:
- Confusion, hallucinations or dementia
- Developmental delays (children)
- Dizziness
- Eye and vision changes (dilated pupils, double vision, light sensitivity, blurred or darkened vision)
- Heartbeat sound behind the ear (pulsatile tinnitus)
- Neck or back pain
- Nausea and vomiting
- Problems with speech, balance, coordination or memory
- Weakness or paralysis in the face or arms on one side
Symptoms of cerebrovascular conditions that affect the spine include:
- Back pain
- Loss of bladder or bowel control
- Muscle weakness, numbness or paralysis
- Numbness, itching, burning or tingling
Find out more about cerebrovascular diagnosis and evaluation
Cerebrovascular Diseases We Treat
Penn’s cerebrovascular specialists provide comprehensive care for all types of cerebrovascular conditions, including:
Stroke
A stroke is a medical emergency that occurs when a blood vessel in the brain becomes blocked (ischemic stroke) or ruptures (hemorrhagic stroke), affecting blood and oxygen flow to the brain.
Our Comprehensive Stroke Center is the largest and best-equipped facility in the area. Certified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), we treat every kind of stroke and stroke complication.
Brain Aneurysm
A brain aneurysm is a bulge that forms in a weakened area in the wall of a brain artery. If the aneurysm ruptures, it can cause a dangerous hemorrhagic stroke. The main types of treatments for aneurysms are aneurysm clipping and endovascular procedures.
Carotid Artery Disease
Carotid artery disease is a narrowing or blockage of the carotid artery that carries blood to your brain. Carotid artery disease is one of the main causes of stroke. Blockages can also occur in other arteries that carry blood to the brain, such as cerebral arteries inside your brain and vertebral arteries that travel up the back of the neck.
Vascular Malformations
Vascular malformations are defects in the blood vessels. They may be present at birth or develop over time. Some vascular malformations run in families.
The types of vascular malformations include:
- Arteriovenous malformations (AVMs), tangles of arteries and veins that bypass the capillaries and connect directly to each other, like dural arteriovenous fistulas (DAVFs).
- Cavernous malformations (cavernomas), which are clusters of enlarged blood vessels that occur in the brain and spinal cord and can leak blood into the surrounding brain tissue. Learn more about cavernoma surgical care through our dedicated Cavernous Malformation Center.
- Venous malformations, which occurs when a mass of veins forms under the skin, often on the head and neck.
- Lymphatic malformations, which are noncancerous masses of lymph vessels that can cause large cysts to develop, often around the neck.
Moyamoya Disease
Moyamoya disease is a progressive disease that causes a narrowing of the carotid arteries. Untreated, moyamoya disease can lead to a stroke. Our cerebrovascular surgeons perform specialized procedures to improve blood flow and reduce stroke risk.
Intracranial Hypertension
Intracranial hypertension is an increase in pressure inside your skull due to a buildup of cerebrospinal fluid. Headaches and vision changes, including vision loss, are the most common symptoms. Stroke, accidents and infections can cause intracranial hypertension.
In idiopathic intracranial hypertension (IIH), venous stenosis may be an underlying cause, but often the cause is unknown.
Hydrocephalus
Hydrocephalus is a buildup of cerebrospinal fluid in the cavities inside your brain (ventricles). This increase in fluid can damage the surrounding brain tissue and cause permanent damage and death. It is most common in infants and older adults but can occur at any age.
Cerebrovascular Disease Care at Penn Medicine
For most cerebrovascular conditions, surgery is the main treatment. However, modern surgery incorporates minimally invasive microsurgery, endovascular surgery and radiosurgery. The type of treatment you receive depends on many unique factors. We develop personalized treatment plans and adjust our approach as needed.
Surgical treatments we offer include:
- Minimally invasive brain microsurgery, like carotid endarterectomy to reroute blood flow in patients with carotid artery disease
- Endovascular neurosurgery, which is a less invasive cerebrovascular approach that treats you from the inside out
- Radiosurgery, including the more precise Gamma Knife® radiosurgery
Learn more about cerebrovascular treatments and procedures offered at Penn
Cerebrovascular Disorder Care at Penn Medicine: Why Choose Us?
Our cerebrovascular specialists understand the complicated nature of cerebrovascular conditions and the unique challenges they present. Our goal is to provide the most effective treatment and the best outlook for your future.
Other benefits of receiving cerebrovascular disease care at Penn Medicine include:
- Complete care: No matter your condition, you deserve expert care. Our specialists have expertise treating all types of cerebrovascular conditions, including rare and complex cerebrovascular disorders that other providers seldom see.
- Multidisciplinary team: Specialists from other Penn departments are available to be part of your care team as needed. We collaborate closely to ensure you receive seamless care. Meet our cerebrovascular team.
- Exceptional staff: Our advanced practice providers, nurses and staff receive subspecialty training. This means they know your condition well and can anticipate your needs.
- Shared decision-making: We consider you and your family equal partners in care. Our medical team encourages family members and caregivers to be at the bedside and participate in care coordination and planning.
Leaders in Cerebrovascular Disease Research
Penn Medicine is a top-funded institution for ischemic and hemorrhagic stroke research. Our doctors are active leaders and participants in clinical trials to understand why these diseases occur and how we can better treat them. Some clinical trials offer eligible patients access to new treatment procedures and devices that aren’t widely available.
Our current research focuses on three areas:
- Determining the cause of aneurysms
- Identifying the source of a clot in people with ischemic stroke
- Studying the outcomes of treatments for bleeding (hemorrhage) inside the brain
Read more about neurosurgery research
“I Trust My Team at Penn”
After suffering with headaches, dizziness and even fainting, Brandie turned to Penn for help. An MRI revealed she had an arteriovenous malformation (AVM), a tangle of abnormal blood vessels in her brain.
Surgery to remove the AVM was Brandie’s best treatment option. With expert care from Penn’s trusted cerebrovascular team, the surgery was a success. Two months later, Brandie’s headaches were gone and she was reclaiming her independence. Watch Brandie’s story.
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