Neurosurgery: Cerebrovascular diseases

Cerebrovascular disease (CVD) can encompass a wide variety of medical acute events, such as ischemic or hemorrhagic stroke, to insidious pathological processes, such as atherosclerotic changes and small-vessel diseases. This chapter focuses on the management of acute ischemic and hemorrhagic stroke, including subarachnoid hemorrhage and venous sinus thrombosis. Stroke is the most common manifestation of CVD disease among adults. It is typically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system by a vascular cause, including cerebral infarction. Common stroke signs and symptoms may include sudden onset of weakness, hemiparesis, monoparesis, or rarely quadriparesis, hemisensory deficits, visual loss or visual field deficits, diplopia, dysarthria, altered speech, aphasia, facial droop, ataxia, vertigo, nystagmus, and sudden decrease in the level of consciousness. The surgical approach to patients with stroke emergencies in some contexts can greatly reduce the unfavorable outcome and mortality.