Syncope (fainting) is an expression of reduced cerebral blood flow. Prolonged standing, emotional arousal, blood pressure drugs, cardiac arrhythmias, and autonomic nervous system failure are common causes of syncope. Blood tends to pool in the legs with prolonged standing. Muscle activity is required to pump venous blood uphill back to the heart.

With reduced venous return, cardiac output drops and humans faint.  A common symptom, the feeling of lightheadedness is an expression of reduced blood flow to the brain.  Since cerebral arterial disease increases with age, decreasing symptoms of limited blood flow become more common such as lightheadedness, fainting, personality changes and deteriorating cognitive ability.

Some of the disturbances will be regional with selectively compromised functions. Other disturbances will be global. The use of medications to reduce blood pressure may have adverse effects because lowering blood pressure can decrease cerebral perfusion in patients with chronic vascular brain pathology; they may develop focal hypoxia and even ischemia in poorly perfused regions of their brain.

The cerebral circulation involves arteries, carrying blood to and veins that take blood away from the brain. There are four cerebral arteries travel through the neck: two carotid arteries that reach the brain through two openings in the base of the skull in the front. Another  pair, the vertebral arteries are branches from the subclavian arteries in the chest, arrive in the back.

The two vertebral arteries reach the brain along the vertebral column and fuse into the basilar artery that supplies blood the brainstem and the back portion of the cerebral hemispheres. The four major arteries are interconnected to form the Circle of Willis, an arrangement that allows sharing of blood flow. This circle provides backup circulation in case one artery is obstructed.

The cerebral veins converge on a central vein under the top and center of the skull that divides to form the two jugular veins that descend in the neck to the right atrium of the heart.

   Solving Cerebral Vascular Disease

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