Cerebrovascular disease refers to a group of conditions affecting the blood vessels that supply the brain. The most important acute manifestation is stroke, which occurs when blood flow to part of the brain is interrupted by a blockage or when a blood vessel in the brain ruptures and causes bleeding.[1,2]
The two major types of stroke are ischaemic stroke, caused by blockage of a blood vessel, and haemorrhagic stroke, caused by rupture of a blood vessel and bleeding in the brain. A transient ischaemic attack (TIA) results from a temporary interruption of blood flow and produces stroke-like symptoms without permanent brain injury.[1]
Global Impact
Stroke is one of the leading causes of death and disability worldwide. Cardiovascular diseases caused approximately 19.8 million deaths globally in 2022, and about 85% of cardiovascular deaths were due to heart attacks and strokes.[2]
The burden of cardiovascular disease is particularly high in low- and middle-income countries, which account for more than three-quarters of cardiovascular deaths worldwide.[2]
Impact in India
Cerebrovascular disease represents an important public health burden in India. Stroke is among the leading causes of death in the country. WHO estimates for 2021 reported stroke mortality rates of approximately 49.3 deaths per 100,000 among men and 57.9 per 100,000 among women in India.[3]
Hypertension is the leading modifiable risk factor for stroke, making early detection and effective control of high blood pressure particularly important for reducing the burden of cerebrovascular disease.[1]
According to the Chandigarh NCD Registry (July 2018–December 2021), 75.4% of stroke cases with information on stroke type were ischaemic, while 24.1% were haemorrhagic. Most stroke cases occurred among individuals aged 45–69 years (58.8%). Hypertension was the most commonly reported pre-existing condition (55.5%), followed by diabetes mellitus (27.0%) and coronary artery disease (13.1%).[4]
Risk Factors
Important risk factors for stroke include high blood pressure, tobacco use, high blood cholesterol, diabetes, overweight and obesity, physical inactivity, unhealthy diet, particularly high sodium intake, harmful use of alcohol, air pollution, atrial fibrillation and other heart conditions and increasing age and previous stroke.[1]
Signs and Symptoms
Stroke symptoms usually appear suddenly and require immediate medical attention. Common warning signs include:
- Sudden weakness or numbness of the face, arm or leg, particularly on one side
- Sudden difficulty speaking or understanding speech
- Sudden loss or disturbance of vision
- Sudden dizziness, loss of balance or coordination
- Sudden severe headache with no known cause.[1,5]
The BE-FAST approach can help recognize stroke: Balance loss, Eye/vision changes, Face drooping, Arm weakness, Speech difficulty and Time to seek emergency medical care.[1]
Treatment and Management
Stroke is a medical emergency, and rapid treatment can reduce brain damage, disability and death. Treatment depends on whether the stroke is ischaemic or haemorrhagic.[1,6]
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- Ischaemic Stroke: Treatment may include medicines that dissolve or prevent blood clots. In eligible patients, mechanical thrombectomy may be used to remove a clot from a blocked brain artery.[6]
- Haemorrhagic Stroke: Treatment focuses on controlling bleeding and pressure in the brain. Medicines, procedures or surgery may be required depending on the location and severity of bleeding.[6]
- Rehabilitation: Following a stroke, rehabilitation may include physiotherapy, occupational therapy, speech and language therapy and psychological support to help individuals regain function and independence.[1]
Prevention
Many strokes can be prevented by addressing modifiable risk factors. Controlling blood pressure, avoiding tobacco, maintaining healthy cholesterol and blood glucose levels, eating a healthy diet, being physically active, maintaining a healthy weight and limiting alcohol consumption can substantially reduce stroke risk.[1,2]
References
- World Health Organization. Stroke. Geneva: World Health Organization; 2025 Dec 19. Available from: https://www.who.int/news-room/fact-sheets/detail/stroke
- World Health Organization. Cardiovascular diseases (CVDs). Geneva: World Health Organization; 2025 Jul 31. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-%28cvds%29
- World Health Organization. India: leading causes of death. Geneva: World Health Organization. Available from: https://www.who.int/data/gho/data/countries/country-details/GHO/india
- Thakur JS, Malhotra P, Bhadada SK, Kapoor R, Vijayvergiya R, Khurana D, Arora P. Chandigarh Noncommunicable Diseases (NCD) Registry, July 2018 to December 2021. Chandigarh: World NCD Federation; 2025.
- National Heart, Lung, and Blood Institute. Stroke symptoms. Bethesda (MD): National Heart, Lung, and Blood Institute; 2023 May 26. Available from: https://www.nhlbi.nih.gov/health/stroke/symptoms
- National Heart, Lung, and Blood Institute. Stroke treatment. Bethesda (MD): National Heart, Lung, and Blood Institute; 2023 May 26 [cited 2026 Sep 9]. Available from: https://www.nhlbi.nih.gov/health/stroke/treatment