Vascular brain diseases, a major challenge for brain health

Stroke

Stroke is the 2nd leading cause of death in the world, with 100 million people affected. A stroke happens when blood flow to part of the brain is suddenly blocked or reduced, leading to immediate problems with brain function.

The causes of stroke vary widely. They can be caused by haemorrhage inside the brain (15-30% of cases) or cerebral infarction (ischemic stroke due to a blockage in one of the blood vessels supplying the brain, 70-85% of cases). The latter may be due to disease of the small cerebral vessels, atheroma (plaque in the arteries), or cardiac sources of embolism (when a blood clot or other substance gets stuck in a blood vessel).

The countries of the Global South are particularly hard hit, accounting for 70% of all stroke deaths worldwide.

Cognitive decline or dementia

Dementia affects 57 million people (a figure that could triple by 2050). Those affected suffer from cognitive decline associated with a loss of independence in their daily life.

The vast majority of cases of dementia in the population are due to the presence of neurodegenerative and vascular lesions in the brain. Unfortunately, the vascular component has been largely overlooked in the majority of therapeutic trials to date.

By 2050, it is expected that 70% of newly diagnosed cases of dementia will occur in countries of the Global South.

Covert cerebral small vessel disease

Covert cerebral small vessel disease (ccSVD), is extremely common in the general population, particularly in elderly people. It can be detected by brain imaging (usually MRI) in people with no history of stroke or dementia. Imaging techniques are able to show the presence of white matter abnormalities, lacunae (small areas of dammage in the brain’s white matter) or microbleeds that are characteristic of ccVSD.

These ‘hidden’ lesions, caused by an alteration in the structure and/or function of the small cerebral vessels, are associated with an increased risk of developing a stroke (cerebral infarction or intracerebral haemorrhage) or dementia. They may be completely silent (with no apparent symptons) or associated with cognitive, balance, walking and mood disorders.

In France, more than five million people over the age of 65 have covert cerebral small vessel disease (i.e. around 40 million people in Europe and several hundred million worldwide).

The VBHI aims to provide populations around the world with strategies to avoid or delay the onset of stroke and dementia, preserving their brain’s ability to age well.