HARD DECISIONS IN INTENSIVE CARE UNIT

Intensivecareunitkapak

CEREBROVASCULAR DISEASES

Mustafa Naci Balıca

Ankara Bilkent City Hospital, Department of Intensive Care, Ankara, Türkiye

Balıca MN. Cerebrovascular Diseases. In: Turan S, editor. Hard Decisions in Intensive Care Unit. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.177-188.

ABSTRACT

Neurovascular diseases, including ischemic and hemorrhagic strokes, aneurysms, and arteriovenous malformations, are significant contributors to global morbidity and mortality. These conditions result from disruptions in cerebrovascular circulation due to factors such as atherosclerosis, hypertension, and genetic predispositions. Advancements in neuroimaging and minimally invasive interventions have improved early diagnosis and treatment, yet challenges remain in optimizing long-term management and prevention. The most common type of stroke, known as an ischaemic stroke, occurs when blood supply to the brain is diminished as a result of either a blood clot or an embolism. Such occurrences frequently result in irreversible deficits of a neurological nature. Hemorrhagic stroke carries a higher risk of mortality due to increased intracranial pressure and brain tissue damage. Current management strategies emphasize rapid intervention, including intravenous thrombolysis, endovascular thrombectomy, and blood pressure control, to minimize brain injury and enhance recovery. Emerging therapies, such as tenecteplase and minimally invasive clot removal, offer potential improvements in stroke outcomes. Stroke rehabilitation plays a crucial role in restoring motor and cognitive function, enhancing quality of life, and promoting functional independence. Multidisciplinary rehabilitation, including physical, occupational, and speech therapies, facilitates neuroplasticity and recovery. This chapter highlights the evolving landscape of neurovascular disease management, emphasizing the importance of early intervention, individualized treatment strategies, and comprehensive rehabilitation. Further research is needed to refine therapeutic approaches, improve long-term outcomes, and reduce the burden of neurovascular diseases worldwide.

Keywords: Neurovascular diseases; Ischemic stroke; Hemorrhagic stroke; Intracranial pressure; Tenecteplase

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