Cerebral Aneurysm

• A cerebral aneurysm (brain aneurysm) is a weak spot of a blood vessel (artery) in the brain that bulges out. 
  • Saccular aneurysm, also referred to as a “berry aneurysm” is a round sac that comes off the artery.
  • Fusiform aneurysm, is an aneurysm that bulges on all sides of the artery.
• Brain aneurysms are frequently diagnosed incidentally during workup for other medical conditions. 
• Risk factors for developing a brain aneurysm include genetics such as connective tissue disorders that weaken the blood vessels or family history, polycystic kidney disease, and cigarette smoking. 
• Risk factors related to aneurysm rupture include untreated high blood pressure, smoking, aneurysm size, and family history. 
• Brain aneurysms can become symptomatic if they are large, compressing a nerve, or prior to rupture. Symptoms include headaches, double vision, extremity weakness or sensory changes. 
• If a brain aneurysm ruptures patients develop a special pattern of bleeding in the brain, also known as subarachnoid hemorrhage. In that setting patients can present with sudden “worst headache of life”, vision changes, sensitivity to light, nausea/vomiting, loss of consciousness, or weakness in extremities. 
  • If you have any of these symptoms, call 911 immediately to seek emergent medical care.

Arteriovenous Malformation (AVM)

• Arteriovenous malformation (AVM) is an abnormal tangle of blood vessels that has an irregular connection between the arteries and veins in the brain or spine. The arteries (high pressure system) are directly connected to the veins (low pressure system) without the middle connection, the capillary system, which normally decreases the pressure of the blood. 
  • Over time the blood vessels within the AVM become weakened causing rupture and bleeding in the brain.
  • If an AVM or arteriovenous fistula is located in the spine it can cause progressive worsening symptoms over several months, which can be mistakenly attributed to degenerative spine disease.
  • If an AVM ruptures, symptoms include headache, seizures, weakness in extremities, vision changes, dizziness or speech difficulties. However, symptoms are variable depending on the location of the AVM. 
    • If you have any of these symptoms, call 911 immediately to seek emergent medical care.

Stroke

• An ischemic stroke happens when an artery in the brain is blocked by a blood clot causing diminished blood flow and oxygen to that area of the brain.
  • An ischemic stroke can occur when a plaque ruptures from your carotid arteries, or when a blood clot travels from elsewhere in the body, usually the heart. 
  • Modifiable risk factors include high blood pressure, diabetes, high cholesterol, cigarette smoking, sedentary lifestyle, and obesity. 
  • Non-modifiable risk factors include age, race, sex, and genetics.
  • Stroke like symptoms that resolve within 24 hours, without residual deficits, constitute a transient ischemic attack (TIA).
    
• A hemorrhagic stroke occurs when a blood vessel bursts causing bleeding in the brain. 
  • A hemorrhagic stroke is caused by high blood pressure, AVM or other vascular malformation, cerebral aneurysm, or the use of blood thinning medications.  
• Symptoms of an ischemic or hemorrhagic stroke include but not limited to acute onset of trouble speaking, facial droop, weakness or numbness in extremities, dizziness, double vision, or difficulty walking. 
  • If you have any of these symptoms, call 911 immediately to seek emergent medical care.

Moyamoya Disease

• Moyamoya disease is a cerebrovascular disorder that affects the blood vessels in the brain causing them to narrow or constrict limiting the flow of oxygen and blood. Other blood vessels are formed to increase circulation to the affected area, however these vessels are small and become easily occluded. 
• Moyamoya means “puff of smoke” in Japanese and describes the look of the blood vessels on angiographic imaging. 
• The cause of the disease is unknown however is more common in Japan, Korea, and China. 
• Risk factors include familial history, Asian decent and female. 
• Moyamoya is diagnosed during workup for cause of a stroke or recurrent transient ischemic attacks. 
• Symptoms are those of a stroke including but not limited to trouble speaking, facial droop, weakness or numbness in extremities, dizziness, or difficulty walking. ​
  • If you have any of these symptoms, call 911 immediately to seek emergent medical care.

Carotid Artery Stenosis

• Carotid artery stenosis is narrowing of the vessel due to atherosclerotic plaque caused by fat, cholesterol, and calcium. The carotid artery is located on each side of the neck and perfuses the front part of your brain. 
• Carotid artery stenosis is usually diagnosed by ultrasound, CTA (computed tomography angiography), MRA (magnetic resonance angiogram) or cerebral angiogram. 
• Risk factors include high blood pressure, diabetes, high cholesterol, cigarette smoking, sedentary lifestyle, and obesity
• When pieces of the plaque break off, clots are formed, which can block blood vessels in the brain. This results in a stroke or a transient ischemic attack.
• If the carotid artery stenosis becomes severe, patients are at higher risk of stroke or transient ischemic attack. Symptoms include trouble speaking, facial droop, weakness or numbness in extremities. 
  • If you have any of these symptoms, call 911 immediately to seek emergent medical care.