What we should know and master about ischemic cerebrovascular disease at the first level of care

Abstract

Cerebrovascular disease is a sudden neurological impairment attributable to a focal vascular cause. The definition of ischemic is oriented when it is due to an obstruction that causes a decrease or absence of blood flow, generally due to a thrombus in the vasculature in situ or an embolization from another place, causing a neuronal energy deficit with subsequent death of the affected neurons. Age is the most important demographic risk factor and although the incidence of cerebrovascular disease has decreased in recent years, the lifetime risk of stroke has increased due to the aging of the population. The clinical manifestations will correspond to the location of the ischemia, but are generally absent or decreased sensory, motor function or both in one half of the body, loss of speech or understanding, vision changes, gait disturbance, and sudden severe headache. The most common etiologies are cardioembolic, arterioarterial embolism and stenosis that limits the flow of a large extracranial vessel. Within the diagnostic tools, the first study of choice is still computed tomography without contrast, basically to show or not a bleeding process to rule out hemorrhagic cerebrovascular disease that may explain the patient's presentation. Lastly, seek the continuous education of our patients, guiding them towards a healthy lifestyle and be attentive in our consultations to see the clinical evolution of these patients.