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Cerebrovascular Accident (CVA) is called a stroke; Could be ischemic or
hemorrhagic
Cerebrovascular accident (CVA), commonly known as a stroke, occurs when
the blood supply to the brain is interrupted or reduced, depriving brain tissue
of oxygen and nutrients. This can result in cell death and brain damage.
Strokes are a medical emergency and require prompt treatment to minimize
brain damage and potential complications.
When a patient has a stroke, also known as a cerebrovascular accident (CVA)
or ICTUS, I cannot stress enough the importance of the time that passes from
the first symptom to the moment of thrombolytic treatment or surgery. This
period is called the “window period.” You only have 4 hours to solve the
problem; otherwise, the consequences can be devastating, such as paralysis on
one side of the body, loss of speech, inability to coordinate thoughts, or even death.
Remember, from the first sign of a stroke, while the family reacts, calls the
ambulance, takes the patient to the wrong hospital (not all hospitals have units
prepared for this treatment), transports them to the appropriate hospital,
performs the CT scan to determine if the stroke is ischemic or hemorrhagic,
and finally enters the treatment room—all of this must happen within 4 hours.
Therefore, the most important thing is to know and share with your family
which is the closest hospital equipped to handle this procedure. Ambulance
personnel will ask you which hospital you want to go to. You need to have
done your homework and know where you want to be taken.
Does this revision work for you?
Types of Strokes:
1. Ischemic Stroke: Caused by a blockage (blood clot) in a blood vessel
supplying the brain.
2. Hemorrhagic Stroke: Caused by the rupture of a blood vessel, leading to
bleeding in the brain.
Causes:
– Ischemic Stroke: Arterial blockages can be caused by atherosclerosis (plaque
buildup), blood clots, or other vascular conditions. Important to remember  acute or chronic fibrillation in your heart (irregular rhythm), coagulopathy as in cancer, genetic, dialysis.
– Hemorrhagic Stroke: High blood pressure, aneurysms, arteriovenous
malformations (AVMs), or blood-thinning medications. 

Symptoms:
– Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
– Sudden confusion, trouble speaking, or understanding.
– Sudden trouble seeing in one or both eyes.
– Sudden trouble walking, dizziness, loss of balance, or coordination.
– Sudden severe headache with no known cause.
Diagnosis:
– Physical examination and medical history.
– Imaging tests such as CT scans or MRI in the 4 hours window period that you
will have. Perhaps this is the most important information to have after an
acute sign of stroke, everyone should know, what is the hospital close to you,
with a specialized team, trained to break the blood clot (thrombectomy). You
have only 4 hours window period to prevent permanent damage in your
brain.
– Blood tests to determine risk factors and assess clotting function.
Acute Treatment:
– Ischemic Stroke: Thrombolytic therapy (clot-busting drugs like tissue
plasminogen activator or tPA) if administered within a few hours of symptom
onset.
– Hemorrhagic Stroke: Control of bleeding, blood pressure management, and
sometimes surgery to repair the blood vessel.
Chronic Treatment:
– Medications to manage risk factors like high blood pressure, high cholesterol,
and diabetes.
– Lifestyle changes such as a healthy diet, regular exercise, and smoking
cessation.
– Rehabilitation therapy including physical therapy, speech therapy, and
occupational therapy.
Prognosis:
– Prognosis varies, depending on the type and severity of the stroke; the time
elapsed before treatment (you have only 4 hours, wrong hospital will delay the
treatment), and individual health factors.
Conclusion:
Cerebrovascular accidents are a leading cause of disability and death
worldwide. Early recognition of symptoms***, prompt medical attention***
(window period 4 hours), and ongoing management of risk factors are crucial in reducing the impact of strokes. Advances in treatment and rehabilitation offer hope for improved outcomes and quality of life for stroke survivors.
Keep in mind, the best treatment is prevention: good control of your diabetes
mellitus, hypertension, high cholesterol, irregular rhythm in your heart. The
other related causes are more difficult to prevent