Cerebral (Latin: cerebrum = brain) ischemia (Greek: ischaimia = to withhold blood) is a type of cerebrovascular disorder and is also referred to as a cerebral infarction or stroke. It is considered the most common type of stroke and results from a sudden reduction in blood flow to the brain. The long-term consequences of this reduced arterial blood supply are often severe and depend on the severity of the event as well as the time elapsed between the onset of the event and the start of treatment.

Causes of Cerebral Ischemia

In 85 percent of all cases, a stroke is caused by a blocked blood vessel. The remaining 15 percent are hemorrhagic strokes, also known as cerebral hemorrhages. In these cases, the trigger is a ruptured blood vessel.

Cerebral ischemia is usually caused by a thrombosis or an embolism:

Thrombosis

In thrombosis, a so-called thrombus (blood clot) forms in the brain, blocking the blood vessel. This is usually caused by deposits in the vessel resulting from atherosclerosis (hardening of the arteries). The brain tissue no longer receives enough oxygen. If this condition persists, the affected nerves and tissue die off. This results in impaired function.

Superficial venous thrombosis in the left leg @ hriana / AdobeStock

The Embolism

In the case of an embolism (vascular occlusion), a blood clot is located outside the brain—for example, in the heart. From there, the thrombus travels through the bloodstream to the brain and causes a blood vessel to become blocked. The cause of blockages in the brain is that arteries become progressively narrower the closer they are to the brain.

Blood Vessels Supplying the Brain (Circle of Willis)

The blood supply to the brain is vital. Two pairs of arteries regulate this supply. Both meet at the base of the brain to form a ring-shaped circle of arteries known as the Circle of Willis (named after the physician Thomas Willis).

If cerebral ischemia occurs below the Circle of Willis, the other arteries can largely take over the blood supply.

If, however, the occlusion occurs above the Circle of Willis—in the cerebral arteries—compensation is no longer possible. This results in permanent damage.

Just ten seconds without an adequate blood supply leads to loss of consciousness. After about two to three minutes, nerve cells die, resulting in damage to the brain tissue.

Illustration of the Circle of Willis @ joshya / AdobeStock

Symptoms of Cerebral Circulatory Disorders

The symptoms associated with reduced blood flow to the brain vary widely and often occur simultaneously. The symptoms vary because different areas of the brain may be affected.

There are also differences in duration. Symptoms may persist continuously or subside.

The most common symptoms are:

Speech disorders
Motor impairments
Numbness on one side of the body
Difficulty understanding
Dizziness
Impaired vision
Severe headaches

If you notice these symptoms in yourself or someone else, you must call emergency services immediately.

The first point of contact is a hospital’s stroke unit. Stroke units specialize in treating stroke patients. Your actions play a crucial role in determining whether the patient survives and whether they will suffer long-term complications.

Diagnosis of Cerebral Circulatory Disorders

Saving lives and minimizing long-term damage depend heavily on a timely and accurate diagnosis. The faster doctors act, the higher the chances of recovery.

The Stroke Unit assesses the severity of the impairments in neurological function. The specialists then evaluate the extent of the damage.

Doctors draw blood from the patient and test for clotting factors and blood sugar levels.

To ensure the patient receives the correct treatment, doctors must determine the exact type of stroke. Patients with cerebral ischemia receive different treatment than those with a cerebral hemorrhage. People with a cerebral hemorrhage often require surgery.

Chances of Recovery from Cerebral Circulatory Disorders

If doctors do not quickly recognize cerebral ischemia, the prognosis is extremely poor. An ischemic stroke is always a medical emergency. Prompt action is crucial.

The main factors that increase the risk of a stroke are:

Smoking
Obesity
High blood pressure
Diabetes mellitus
Chronic lack of physical activity

If you are a high-risk patient and suffer from memory problems, you should definitely see a doctor.

Atherosclerosis detected early is highly treatable. A healthy lifestyle and medication significantly reduce the risk of stroke.

Treatment of Cerebral Circulatory Disorders

If a patient suffers a stroke, the first six hours are critical for the chances of recovery. Within this timeframe, drug therapy is often still possible.

The most important procedure here is what’s known as lysis (Greek: to dissolve). The doctor administers injections that dissolve the clot.

Another option is the stent retriever (mesh device). The stent retriever is an instrument that doctors use in stroke treatment. Specialists guide the stent retriever through the femoral artery to the blocked artery. The clot gets caught in the mesh and can thus be removed.

Mechanical thrombectomy for the treatment of acute ischemic stroke @ songkram / AdobeStock

If these two methods are no longer effective, therapeutic interventions that help improve long-term outcomes can still be beneficial. Rehabilitative measures (physical therapy, occupational therapy, or speech therapy exercises) can minimize the extent of residual damage.

Specialists in Cerebral Circulatory Disorders

Various medical specialists are responsible for treating cerebrovascular disorders:

The neurologist is a specialist in brain and nervous system disorders and is therefore primarily the treating physician. The internist (internal medicine) contributes expertise in the field of vascular diseases. The cardiologist is responsible for heart diseases and the connection between a blood clot in the heart and stroke.

Depending on the precise diagnosis, other specialties may be involved, including vascular surgeons and radiologists.

Conclusion

Cerebral ischemia is the most common type of stroke. It is caused by an acute reduction in blood flow to the brain. The symptoms that occur depend on exactly where the doctor locates the blood flow disturbance. A stroke is a medical emergency and must be treated promptly in a stroke unit. The chances of recovery depend primarily on how quickly treatment begins and on the severity of the event.

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