Cerebrovascular disease.

Cerebrovascular disorders producing transient or permanent symptoms and signs are very common, but they are not the only causes of a sudden neurologic deficit. Careful examination of the cardiovascular system may indicate the likely cause of the lesion, while accurate neurologic localization is also useful in establishing a diagnosis and prognosis. The CT scan is very helpful in distinguishing infarction from haemorrhage. In the management of the acute lesion, treatable disorders such as systemic diseases, potentially fatal rostro-caudal herniation, haematomas and aneurysms always need to be positively exlcuded. Endarterectomy, platelet inhibitors and anticoagulants are advised in certain situations, although their place in the management of cerebrovascular disorders still remains somewhat controversial.