Neurovascular disorders impact the blood vessels and blood supply to the brain, spinal cord, and peripheral nerves. There are several types.

Stroke

Stroke is when disruption of blood flow to your brain causes brain cell death from lack of oxygen. Strokes are either:

• Ischemic: This occurs when something blocks the vessels supplying blood to the brain. The blockage might be a clot or a narrowed vessel.
• Hemorrhagic: This occurs when a blood vessel in the brain breaks, leading to bleeding in or around the brain. The resulting pressure on the brain damages its tissues.

Sometimes, your stroke symptoms go away after a few minutes. This is a transient ischemic attack (TIA), or "mini-stroke," which temporarily blocks blood flow to the brain. It often resolves within minutes or hours but can come back or cause a stroke and should not be ignored. 

Stroke and TIA are medical emergencies. If you think you or someone else is having a stroke, call 9-1-1 right away.

Brain aneurysm

A ruptured aneurysm often causes hemorrhagic strokes. An aneurysm is a weakened, bulging section of a blood vessel. When an aneurysm occurs in the brain, it's called a brain aneurysm. Aneurysms don't always rupture, though they might if left untreated.

Vascular malformations

Another cause of hemorrhagic stroke is a vascular malformation. These are abnormal connections between blood vessels. They disrupt normal blood flow and can lead to bleeding, seizures, or neurological problems.

The most common type is arteriovenous malformation. Tangles of blood vessels cause blood to flow directly from arteries into veins. This increases pressure on the veins, causing them to rupture and bleed.

Carotid stenosis

Carotid stenosis is the narrowing of the carotid arteries in the neck. They supply blood to the brain. A buildup of plaque (atherosclerosis) narrows the arteries and reduces blood flow to the brain. This increases the risk of clots, stroke, and TIA.

In stroke care, "time is brain"—immediate medical intervention can save brain cells. Every minute of delay in care can lead to the loss of millions of brain cells. Rapid response is essential to minimize brain damage and improve outcomes. Recognizing the signs of a stroke can save a life and reduce the risk of long-term disability. 

The key signs follow the acronym BE FAST:

• Balance is unsteady: A person is wobbly on their feet
• Eyesight changes: A person may have blurry vision or trouble seeing
• Face is drooping: One side of the face may droop or feel numb
• Arms are weak or numb: There may be sudden weakness or numbness in one arm
• Speech difficulty: A person’s speech may become slurred, or they can't understand you
• Time to call 9-1-1: If any of these symptoms are present, call emergency services immediately

Your stroke treatment begins with the paramedics in the ambulance. Don't drive yourself or have someone else drive to the hospital. Emergency care is essential during a stroke.

Once at the hospital, we'll do a CT scan of your brain to determine what type of stroke you had. When we know that you've had a clot or brain bleed, you'll get acute stroke care to restore blood flow in the brain. You'll get treatments to help prevent another stroke. And eventually, you’ll get rehabilitation to treat the side effects of stroke. 

At Carilion, we're very experienced in acute stroke care. The stroke experts at Carilion Roanoke Memorial Hospital are on call 24/7. Carilion community hospitals can access the Telestroke network for remote consultations and quick decision-making.

At the emergency room for an ischemic stroke, you'll get thrombolytic therapy using "clot-busting" drugs or blood thinners to prevent further clotting. If you've had a hemorrhagic stroke, the doctors will find the source of the bleeding and control it using surgery or another procedure.

Our neuro-interventional radiology team may use minimally invasive approaches to break apart the clot or fix your aneurysm. Our team uses state-of-the-art, image-guided techniques. Benefits include shorter hospital stays, reduced recovery times, and decreased risks.

You're likely to have lingering symptoms of your stroke, even after we’ve treated it. Many people can recover fully, while others have longer-term issues. Often, a full recovery requires work in a rehabilitation setting.

We need to repair an aneurysm that causes a stroke. However, not all aneurysms require immediate treatment. Factors like the aneurysm's size, location, and your overall health determine your treatment options. They may include:

• Clipping: A metal clip around the neck of an aneurysm prevents it from rupturing
• Coiling: A very thin metal wire is inserted into the aneurysm, where it forms a coil to block blood flow

If you have carotid stenosis, Carilion neurosurgeons can perform a carotid endarterectomy, which removes blockages from the carotid arteries. In some instances, neuro-interventional radiology team may use minimally invasive techniques to open the blockage with a stent. The procedure can help prevent stroke.