Today in Health & Wellness
HEALTH CONDITIONS
Cerebrovascular Accident
Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult
Overview

Common name

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.

 

 

Common name

Stroke; brain attack (Eng.)

Symptoms
  • Dizziness
  • Loss of balance and coordination
  • Trouble walking
  • Difficulty speaking or understanding the words of others
  • Numbness or paralysis on one side of the body
  • Blurred or darkened vision
  • Sudden headache
  • Confusion, memory loss

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.

Risk Factors
  • 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
  • family history of stroke
  • Age. At least 55 years old
  • Unhealthy lifestyle. Obesity, physical inactivity, heavy or binge drinking, use of illicit drugs

 

Complications

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.
Treatment and Management
  • After managing the damaged blood vessel, rehabilitation is done on stroke patients to help regain their strength and normal body functions.
  • Speech therapy can be done if speech and language disorders arise due to stroke.

 

Surgical procedures

  • Carotid endarterectomy. The surgeon removes the fatty plaques located on the carotid arteries which are found along each side of the neck towards the brain. This reduces the risk of having another stroke or a TIA.
  • Angioplasty and stents. A balloon is used to expand the narrowed artery. A stent can be placed to maintain the opened artery.
  • Surgical procedures to control the bleeding and reduce the pressure in the brain can be done on patients suffering from a hemorrhagic stroke.
  • Surgical clipping. A tiny clip or clamp is placed at the base of an aneurysm or the ruptured blood vessel. This prevents the blood flow into the damaged blood vessel to keep it from bursting or re-bleeding.
  • Coiling or endovascular embolization. Tiny detachable coils are placed on the ruptured blood vessel. These block blood flow and promote blood clot.
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