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Understanding Cerebrovascular Disease


In the United States, cerebrovascular disease is the fifth leading cause of death, accounting for 1 of every 19 deaths and a significant cause of severe long-term disability. Cerebrovascular disease is a term for conditions that affect blood flow to the brain, often from ischemic or hemorrhagic stroke.  

Blood is delivered to the brain through the carotid and vertebral arteries. The carotid arteries begin in the neck and continue into the skull before branching into several smaller arteries called the Circle of Willis. The vertebral arteries travel along the spinal column and eventually form a single artery near the brain stem. As blood is delivered to the brain through only two sets of major arteries, early detection of cerebrovascular disease is critical to reducing risk of stroke.  

Our simonONE Plus scan includes MRA imaging sequences for a detailed assessment of these arteries. Magnetic resonance angiography (MRA) utilizes various imaging techniques to create a 3D reconstruction of your cerebrovasculature. The images are reviewed by our board certified neuroradiologists to screen for conditions like carotid artery stenosis or cerebral aneurysms.  

A common underlying cause of an ischemic stroke is narrowing of the carotid arteries due to the buildup of plaque. In a hemorrhagic stroke, an artery has burst open, often due to weakening and bulging of the vessel wall from an aneurysm. Without oxygen, permanent damage or death of brain tissue can occur within only a few minutes. Management of risk factors including hypertension, hyperlipidemia, diabetes, and smoking cessation can reduce your risk of cerebrovascular disease.  

We are sharing 5 simonONE patient imaging findings demonstrating how previously unknown cerebrovascular disease was detected through the utilization of MRA imaging.  

A greater than 5mm aneurysm was found in the left middle cerebral artery of a patient in their early 40’s.  

Narrowing of the right vertebral artery in a patient in their 40’s who had been experiencing dizziness, vision changes, and nausea in the months leading to their simonONE scan. 

Suspected presence of prominent plaque and stenosis to the right carotid bifurcation in a patient without a known history of hypertension, hyperlipidemia, diabetes, or tobacco use.  

Middle cerebral artery atherosclerotic stenosis along with a lesion in the frontal lobe suspicious for a chronic lacunar infarction in a patient without any neurologic symptoms or known stroke history. This patient’s imaging shows signs of a “silent stroke or a stroke that doesn’t cause any noticeable symptoms. Once you experience a silent stroke, your risk of vascular dementia and suffering additional strokes in the future may increase.

Left posterior communicating artery aneurysm with preceding vessel stenosis.  

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