Cerebrovascular disease and white matter disorders

Stroke is the leading cause of disability and fifth major cause of mortality in US. Not all strokes result in observable clinical symptoms. The prevalence of silent strokes in the Framingham offspring study was about 10%. These "silent" strokes, or perhaps less "eloquent" strokes, are part of the white matter disorders related to cerebrovascular disease. The risk of stroke increases with age, doubling for each successive decade after 55 years of age. The goals of general emergency management in acute stroke are to stabilize the patient, facilitate cerebral perfusion, and prevent medical complications such as aspiration. A brain imaging study is performed in all patients with suspected stroke. Computer tomography (CT) is widely available, less expensive, and easy to perform, taking only a couple of minutes to scan the brain. The acute neurological complications of ischemic stroke include malignant brain edema, hemorrhagic transformation of ischemic stroke, and seizures.