Cerebral arteriosclerosis is a disease of the cerebral vessels characterized by thickening, hardening, and loss of elasticity in the arterial walls. The condition alters the function of tissue and the brain. The term, arteriosclerosis, is used as a generic term for several diseases in which the arterial wall becomes thickened and loses elasticity. The most common form of arteriosclerosis is atherosclerosis from which most vascular brain injury is secondary.

Etiologic factors related to the development of this condition may include: vasculitis; atherosclerosis; arterial dissection or hypercoagulable states. Risk factors for the development of the condition include: increasing age; family history of early onset of atherosclerosis; sedentary lifestyle; hypertension; elevated serum lipids; cigarette smoking; and diabetes mellitus. Other risk factors may involve obesity, being of the male sex and inability to cope with stress.

Manifestations of cerebral arteriosclerosis will depend on the area of the brain that becomes ischemic and may include: intermittent claudication; changes in skin temperature; intensity of pulse; headache; dizziness; or memory defects. Signs and symptoms of a carotid artery obstruction may include blindness, paralysis, and aphasia. An embolism of the vertebrobasilar system may be characterized by confusion; vertigo; blindness; slurred speech; diplopia; dysphagia; unsteady gait; and tingling of extremities.

Tests may include: ultrasonography; cerebral arteriogram; and magnetic resonance imaging (MRI). Other diagnostic measures may include: lumbar puncture; ophthalmoscopy; electrocardiogram (EKG); electroencephalogram (EEG); and complete blood count (CBC); coagulation tests; and urinalysis.

Treatment may include: antiplatelet agents; anticoagulants; and, for some, vascular surgery may be indicated.

The extent of the brain affected by ischemia and the immediacy of treatment will determine the outcome. Manifestations may range from tingling of the extremities to death. Conditions that may result include, but are not limited to: transient ischemic attacks (TIA), ischemic strokes, and intracerebral bleeding. Visual disturbances, paralysis, aphasia, diplopia, dysarthria, numbness and unsteady gait may persist, and, as a result, rehabilitation measures and physical therapy would be required.

• "Purely neurological disabilities, such as hemiplegia, cranial nerve paralysis, etc., due to cerebral arteriosclerosis will be rated under the Diagnostic Codes dealing with such specific disabilities, with citation of a hyphenated Diagnostic Code (e.g., 8046-8207)." 

• "Purely subjective complaints such as headache, dizziness, tinnitus, insomnia, or irritability, recognized as symptomatic of a properly diagnosed cerebral arteriosclerosis, will be rated 10 percent and no more under Diagnostic Code 9305. This 10 percent rating will not be combined with any other rating for a disability due to cerebral or generalized arteriosclerosis. Ratings in excess of 10 percent for cerebral arteriosclerosis under Diagnostic Code: 9305 are not assignable in the absence of a diagnosis of multi-infarct dementia with cerebral arteriosclerosis."

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• The ratings under code 8046 apply only when the diagnosis of cerebral arteriosclerosis is substantiated by the entire clinical picture and not solely on findings of retinal arteriosclerosis.