Common neurovascular conditions
Ischemic stroke, caused by blocked blood flow to the brain, accounts for approximately 80% of strokes. Hemorrhagic stroke, caused by bleeding into or around the brain, accounts for the remaining 20%. Transient ischemic attack (TIA) produces stroke-like symptoms that resolve within 24 hours and signals high short-term stroke risk � TIA is a medical emergency requiring urgent evaluation.
Other neurovascular conditions include cerebral venous sinus thrombosis (blood clots in brain veins), subarachnoid haemorrhage (bleeding around the brain, often from aneurysm rupture), and intracerebral haemorrhage (bleeding within brain tissue). Each requires specific acute management and secondary prevention strategies. Carotid artery disease, vertebral artery disease, and small vessel disease contribute to ischemic stroke risk and may be treatable with medication or intervention.
- Ischemic stroke � blocked blood flow, 80% of strokes
- Hemorrhagic stroke � bleeding into/around brain, 20% of strokes
- TIA � temporary symptoms, high stroke risk, emergency
- Carotid/vertebral artery disease � treatable risk factors
- Small vessel disease � chronic ischemic changes
Related: Stroke Doctor → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
Vascular risk factor management
Hypertension is the single most important modifiable risk factor for stroke. Blood pressure control below 130/80 mmHg when tolerated significantly reduces both first and recurrent stroke risk. Diabetes management, cholesterol optimization (statin therapy for most ischemic stroke patients), smoking cessation, and lifestyle modification contribute to secondary prevention. Atrial fibrillation, when present, requires anticoagulation to prevent cardioembolic stroke.
Lifestyle factors including regular physical activity, heart-healthy diet (Mediterranean pattern), weight management, and moderate alcohol consumption reduce vascular risk. Sleep-disordered breathing (obstructive sleep apnoea) worsens vascular risk and should be screened for and treated. Dr. Jitendra Prasad Yadav (NMC 8029) provides comprehensive vascular risk assessment and management planning at Kathmandu Neurology Clinic, Durbar Marg, Opposite of Yak & Yeti Hotel.
| Risk Factor | Target | Impact |
|---|---|---|
| Blood pressure | Below 130/80 mmHg when tolerated | Most important modifiable factor |
| Diabetes | HbA1c individualized, typically below 7-8% | Significantly increases stroke risk |
| Cholesterol | LDL below 70 mg/dL for ischemic stroke | Reduces recurrent ischemic events |
| Smoking | Complete cessation | Each cigarette acutely raises vascular risk |
| Atrial fibrillation | Anticoagulation | Prevents cardioembolic stroke |