Vascular Diseases: Ischemic Stroke, Intracerebral and Subarachnoid Hemorrhage, Cerebral Venous Thrombosis, Arterio-Venous Malformations

This chapter discusses the three subtypes of stroke, namely ischemic (IS) accounts for 85%, intracerebral hemorrhage (ICH) for 10%, and subarachnoid hemorrhage (SAH) for 5%. It discusses the background, prevention, screening, diagnosis, treatment and prognosis for vascular diseases such as IS, ICH, SAH, cerebral venous thrombosis, and arterio-venous malformations (AVM). IS and ICH present with the abrupt onset of focal neurologic symptoms and signs while SAH presents with sudden, severe headache and stiff neck but infrequently with focal deficits. Prompt thrombolytic treatment in appropriate patients can markedly improve the outcome in IS, while in ICH and SAH attention must be focused on reducing the amount of bleeding and the risk of recurrent hemorrhage or other complications such as hydrocephalus and vasospasm. Control of risk factors, especially hypertension, can significantly reduce the risk of initial and recurrent stroke.