Cerebrovascular Accident: Symptoms and Treatment

Overview

Cerebrovascular accident (CVA), also called
stroke, happens when the brain lacks enough oxygen to function properly. In
this case, the blood flow to the brain is stopped either by a blockage or the
rupture of a blood vessel. And then brain cells start to die suddenly. This can
cause lasting brain damage, long-term disability, or even death.

CVA IS the second leading cause of death worldwide and the third leading cause of death in the U.S, according to the American Heart Association. Each year, about 600,000 strokes occur in the United States, 25 percent of which are fatal ones.

Causes

Cerebrovascular disease happens for a variety of reasons.

  • Previously hardening of the artery will narrow a blood vessel and produce a clot(thrombosis). The clot enters the blood circulation and lodge in an artery of the brain after becoming lose. When it blocks and stops the flow of blood, an embolic stroke occurs naturally.
  • When the heart beats irregularly, a blood clot can form in a chamber of the heart. Such clots usually stay attached to the inner lining of the heart. But they may break off sometimes, form a plug (embolus) in a brain artery and cause a stroke.
  • An atherosclerosis occurs when a blood vessel in the brain widens or weakens because of bleeding in the brain.
  • A blocked artery may cause an ischemic stroke.
  • The leaking or bursting of a blood vessel may lead to a hemorrhagic stroke.
  • A temporary disruption of blood flow to the brain may result in a transient ischemic attack, or TIA.

Symptoms

The symptoms of cerebrovascular accident
depend on what area of the brain has stopped working, and the severity of
affected cerebral tissue.

Common symptoms that patients may
present include:

  • a severe and sudden headache
  • acute onset of weakness
  • acute change in level of consciousness or confusion
  • paralysis or numbness of half or part of the body
  • weakness on one side (hemiparesis)
  • difficulty communicating, including slurred speech
  • Double vision
  • loss of balance

The symptoms of ischemic and hemorrhagic stroke may be the same, but patients with hemorrhagic stroke may experience headache and vomiting more frequently.

Diagnosis

The purpose of diagnosis is to evaluate the type of stroke and
the areas of brain affected by the stroke, and to rule out other possible
causes of symptoms.

At
the hospital, a doctor will ask about the patient’s medical history and look
for specific neurological, motor, and sensory deficits. The doctor may also perform
the following tests:

  • Physical examination.
  • Blood tests.
  • Computerized tomography (CT) scan.
  • Electrocardiogram (EKG or ECG)
  • Magnetic resonance imaging (MRI).
  • Carotid ultrasound.
  • Cerebral angiogram. vertebral angiogram, or carotid angiogram

Treatment

Treatment for a cerebrovascular accident vary depending on its
type, either an ischemic stroke or a hemorrhagic stroke.

Ischemic stroke

The
major task of treating an ischemic stroke is to restore blood flow to brain.

Medications:

  • Intravenous injection of tissue plasminogen activator (IPA).
  • IPA delivered directly to the brain.

Surgeries

  • Removing the clot with a stent retriever
  • Carotid endarterectomy

A carotid endarterectomy involves removing plaques
from arteries. This allows the blood to flow again. The artery is repaired with
sutures or a graft.

  • Angioplasty and stents

In an angioplasty, a surgeon usually accesses your carotid
arteries through an artery in your groin.

Hemorrhagic
stroke

The
treatment of hemorrhagic stroke focuses on controlling bleeding and reducing
pressure in brain.

Medications:

  • Drugs or
    transfusions of blood products to counteract the blood thinners’ effects
  • Drugs to
    lower pressure in brain, lower the blood pressure, prevent vasospasm or prevent
    seizures

Surgeries:

  • Surgical blood vessel repair

Surgery may be used to repair blood vessel abnormalities
associated with hemorrhagic strokes.

  • Surgical clipping

A surgeon places a tiny clamp at the base of the aneurysm, to
stop blood flow to it.

  • Coiling (endovascular embolization)
  • Surgical AVM removal
  • Stereotactic radiosurgery

Preventive measures

Medications:

  • Blood
    platelet inhibitors

Dipyridamole, Ticlopidine, and Clopidogrel are blood platelet inhibitors that reduce the risk of stroke before it happens.

  • cholesterol-lowering
    medications

Statins are useful in treating cerebrovascular
accident by decreasing the risk of ischemic stroke.

  • thrombolytic
    drugs

These drugs are used to dissolve the clot
that is obstructing blood flow to the brain

Surgeries:

  • Carotid
    endarterectomy

A carotid
endarterectomy prevents a cerebrovascular accident or a recurrent
cerebrovascular accident.

  • A surgery to relieve pressure in the brain and treat the brain aneurysm.

Keywords: cerebrovascular accident, CVA.

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