Cerebrovascular interactions in cerebral disorders (stroke, transient ischaemic attacks, microvascular disease, migraine)

Abstract

The complexity of the interaction between the blood and brain is well known since the hemato-encephalic barrier (BEE) was firstly described. Most of the neurological diseases lead to BEE disruption. In this chapter, we will focus the attention on the neurological deficits due to vascular impairment. In particular we will analyse the clinical manifestation, pathogenic mechanisms and therapy of stroke, transient ischaemic attack (TIA), microvascular disease and migraine. Stroke and TIA are the most frequent neurological diseases. Stroke is the third leading cause of death and the first cause of disability in western countries. TIA is a risk factor for stroke development and might be considered itself a microscopic stroke. Small-vessel diseases are the first cause of vascular dementia and may also play a role in neurodegenerative diseases. Finally migraine, a common benign neurological disease, represents a good example of the interaction between arterial cells (endothelial and blood cells) and neurons.