What is a cerebrovascular accident?
Cerebrovascular accident (CVA) is the medical term for a stroke. A stroke is when blood flow to a part of your brain is stopped either by a blockage or the rupture of a blood vessel. There are important signs of a stroke that you should be aware of and watch out for.
Seek medical attention immediately if you think that you or someone around you might be having a stroke. The more quickly you receive treatment, the better the prognosis, as a stroke left untreated for too long can result in permanent brain damage.
There are two main types of cerebrovascular accident, or stroke: an ischemic stroke is caused by a blockage; a hemorrhagic stroke is caused by the rupture of a blood vessel. Both types of stroke deprive part of the brain of blood and oxygen, causing brain cells to die.
An ischemic stroke is the most common and occurs when a blood clot blocks a blood vessel and prevents blood and oxygen from getting to a part of the brain. There are two ways that this can happen. One way is an embolic stroke, which occurs when a clot forms somewhere else in your body and gets lodged in a blood vessel in the brain. The other way is a thrombotic stroke, which occurs when the clot forms in a blood vessel within the brain.
A hemorrhagic stroke occurs when a blood vessel ruptures, or hemorrhages, and then prevents blood from getting to part of the brain. The hemorrhage may occur in any blood vessel in the brain, or it may occur in the membrane surrounding the brain.
The quicker you can get a diagnosis and treatment for a stroke, the better your prognosis will be. For this reason, it’s important to understand and recognize the symptoms of a stroke.
Stroke symptoms include:
- difficulty walking
- loss of balance and coordination
- difficulty speaking or understanding others who are speaking
- numbness or paralysis in the face, leg, or arm, most likely on just one side of the body
- blurred or darkened vision
- a sudden headache, especially when accompanied by nausea, vomiting, or dizziness
The symptoms of a stroke can vary depending on the individual and where in the brain it has happened. Symptoms usually appear suddenly, even if they’re not very severe, and they may become worse over time.
Remembering the acronym “FAST” helps people recognize the most common symptoms of stroke:
- Face: Does one side of the face droop?
- Arm: If a person holds both arms out, does one drift downward?
- Speech: Is their speech abnormal or slurred?
- Time: It’s time to call 911 and get to the hospital if any of these symptoms are present.
Healthcare providers have a number of tools to determine whether you’ve had a stroke. Your healthcare provider will administer a full physical examination, during which they’ll check your strength, reflexes, vision, speech, and senses. They’ll also check for a particular sound in the blood vessels of your neck. This sound, which is called a bruit, indicates abnormal blood flow. Finally, they will check your blood pressure, which may be high if you’ve had a stroke.
Your doctor may also perform diagnostic tests to discover the cause of the stroke and pinpoint its location. These tests may include one or more of the following:
- Blood tests: Your healthcare provider may want to test your blood for clotting time, blood sugar levels, or infection. These can all affect the likelihood and progression of a stroke.
- Angiogram: An angiogram, which involves adding a dye to your blood and taking an X-ray of your head, can help your doctor find the blocked or hemorrhaged blood vessel.
- Carotid ultrasound: This test uses sound waves to create images of the blood vessels in your neck. This test can help your provider determine if there’s abnormal blood flow toward your brain.
- CT scan: A CT scan is often performed soon after symptoms of a stroke develop. The test can help your provider find the problem area or other problems that might be associated with stroke.
- MRI scan: An MRI can provide a more detailed picture of the brain compared to CT scan. It’s more sensitive than a CT scan in being able to detect a stroke.
- Echocardiogram: This imaging technique uses sound waves to create a picture of your heart. It can help your provider find the source of blood clots.
- Electrocardiogram (EKG): This is an electrical tracing of your heart. This will help your healthcare provider determine if an abnormal heart rhythm is the cause of a stroke.
Treatment for stroke depends on the type of stroke you’ve had. The goal of treatment for ischemic stroke, for instance, is to restore the blood flow. Treatments for hemorrhagic stroke are aimed at controlling the bleeding.
Ischemic stroke treatment
To treat an ischemic stroke, you may be given a clot-dissolving drug or a blood thinner. You may also be given aspirin to prevent a second stroke. Emergency treatment for this type of stroke may include injecting medicine into the brain or removing a blockage with a procedure.
Hemorrhagic stroke treatment
For a hemorrhagic stroke, you may be given a drug that lowers the pressure in your brain caused by the bleeding. If the bleeding is severe, you may need surgery to remove excess blood. It’s also possible that you will need surgery to repair the ruptured blood vessel.
There’s a recovery period after having any kind of stroke. The length of recovery varies depending on how severe the stroke was. You may need to participate in rehabilitation because of the stroke’s effects on your health, particularly any disabilities it may cause. This can include speech therapy or occupational therapy, or work with a psychiatrist, neurologist, or other healthcare professional.
Your long-term outlook after a stroke depends on a few factors:
- the type of stroke
- how much damage it causes to your brain
- how quickly you’re able to receive treatment
- your overall health
The long-term outlook after an ischemic stroke is better than after a hemorrhagic stroke.
Common complications resulting from a stroke include difficulty speaking, swallowing, moving, or thinking. These can improve over the weeks, months, and even years after a stroke.
There are many risk factors for having a stroke, including diabetes, atrial fibrillation, and hypertension (high blood pressure).
Correspondingly, there are many measures you can take to help prevent stroke. Preventive measures for stroke are similar to the actions that you would take to help prevent heart disease. Here are a few ways to reduce your risk:
- Maintain normal blood pressure.
- Limit saturated fat and cholesterol intake.
- Refrain from smoking, and drink alcohol in moderation.
- Control diabetes.
- Maintain a healthy weight.
- Get regular exercise.
- Eat a diet rich in vegetables and fruits.
Your healthcare provider may prescribe medications for preventing stroke if they know you’re at risk. Possible preventive medications for stroke include drugs that thin the blood and prevent clot formation.