Stroke; brain attack (Eng.)
Cerebrovascular accident (CVA) includes disorders that manifest with a sudden onset of a problem on the nerves, spinal cord and brain function. This is caused by blockage or rupture of a blood vessel in the brain leading to an inhibition of blood flow. Brain tissue deprived of blood and oxygen eventually dies and losses its function. It usually affects a specific part of the body such as the left side of the face or even an area of the tongue.
Types of Cerebrovascular Accident:
- Ischemic stroke occurs when a blood clot blocks a blood vessel within the brain. This prevents the blood and oxygen from reaching a part of the brain. In an embolic stroke, the blood clot is formed in another part of the body and travels to the blood vessels in the brain. In a thrombotic stroke, the blood clot is formed in the blood vessel of the brain.
- Hemorrhagic stroke is caused by a ruptured blood vessel which prevents the blood from reaching a part of the brain. The blood vessel involved can be found within the brain or on the membrane surrounding the brain. In an intracerebral hemorrhage, the affected blood vessel is within the brain causing blood to spill into the brain tissue and cause damage to the brain cells. In subarachnoid hemorrhage, the artery that burst is found on or near the surface of the brain. Blood leaks in the area between the surface of the brain and the skull.
- Transient ischemic attack (TIA) is a temporary cerebrovascular disorder wherein the blood flow is impaired for a short period of time. The symptoms usually last for 5 to 10 minutes and should resolve within 24 hours. This type of CVA do not cause permanent neurologic damage.
Initial diagnosis of CVA is done through a full physical examination. Physicians also check an abnormal sound called a bruit on the blood vessels of the neck because this indicates an abnormal blood flow. Patients who have stroke usually have a high blood pressure. Imaging tests can be done to determine the exact location of the affected blood vessels. Some of the tests include angiogram, carotid ultrasound, CT scan and MRI.
Stroke; brain attack (Eng.)
Loss of balance and coordination
Difficulty speaking or understanding the words of others
Numbness or paralysis on one side of the body
Blurred or darkened vision
The acronym FAST helps remember what to look for when stroke is suspected:
Face drooping – When the patient smiles, one side of the face is drooping or points downward.
Arm weakness – When the patient raises both arms, one arm drifts downward.
Speech difficulty – When a person repeats a simple sentence, there is trouble speaking or slurring of the words.
Time to call for help – If the patient shows any of the symptoms mentioned, immediately seek for medical attention.
- Chronic diseases. Hypertension, dyslipidemia, diabetes
- Exposure to tobacco. Cigarette smoking or exposure to secondhand smoke
- Obstructive sleep apnea. A sleep disorder wherein the oxygen level drops during the night
- Cardiovascular disease. Heart failure, heart defect, heart infection or arrhythmia
- Age. At least 55 years old
- Unhealthy lifestyle. Obesity, physical inactivity, heavy or binge drinking, use of illicit drugs
Complications due to stroke can be temporary or permanent. The severity depends on how soon the treatment was given and the location of the damaged blood vessel.
- Paralysis or loss of muscle movement. One side of the body can become paralyzed. Some muscles may not be controlled such as facial muscles on one side or muscles on one arm.
- Difficulty talking or swallowing. Muscles of the mouth and throat can become difficult to control causing problems in talking clearly, swallowing or eating.
- Memory loss or thinking difficulties. Some memory loss can be experienced. Other patients have difficulty thinking, reasoning, and understanding.
- Emotional problems. Some have difficulty controlling their emotions. This can lead to depression.
- Pain. Pain, numbness or other sensations can be felt on the affected body parts during the stroke.
Commonly Prescribed Drugs
Emergency treatment with medications is done to address an ischemic stroke. The main goal is to dissolve the blood clot and restore blood flow to the brain.
- Aspirin is an antiplatelet immediately given to prevent more blood clots from forming and reduce the risk of having another stroke.
- Tissue plasminogen activator (tPA) is administered intravenously to dissolve the blood clot and restore blood flow to the brain. This should be given within 3 to 4.5 hours of the onset of stroke symptoms. An example of a tPA is alteplase.