Cerebrovascular Accident (CVA)

A cerebrovascular accident or CVA is a medical term for a stroke. When blood flow to a region of the brain is disrupted by a blockage or a blood vessel rupture, a CVA develops.

Associated Anatomy

• Brain
• Central nervous system

Alternate Name

• Brain attack
• Stroke

Cerebrovascular accident or CVA Causes

• High Blood Pressure: An excessively high blood pressure known as hypertension could be a culprit.
• Smoking Tobacco: Smoking or chewing tobacco increases the chances of having a stroke.
• Heart Disease: This disorder involves cardiac valve problems like atrial fibrillation, or an irregular heartbeat, which accounts for a quarter of all strokes in the elderly.
• Diabetes: The damage to the brain is worse when your blood sugar levels are high.
• Weight and Exercise: Obesity and being overweight can increase the chances of having a stroke.
• Medications: Blood-thinning medicines, and hormone therapy, are related to an increased risk of stroke in studies.

Cerebrovascular Accident (CVA) Symptoms

• Difficulty in speech and understanding what others speak
• Perplexed, slur words, or have trouble understanding speech
• The face, arm, or leg, experiences abrupt numbness, weakness, or paralysis
• It affects one side of the body
• Unable to raise both arms above the head at the same time
• One arm begins to fall
• When trying to smile, one side of the mouth may droop
• One or both eyes have vision problems
• Double vision or blurred or darkened vision in one or both eyes
• A severe headache
• Trouble walking and loss of coordination and balance while walking
• The person may trip down, losing balance.

Typical Test for Cerebrovascular Accident (CVA)

• CT scan of the head

To identify a stroke caused by a blood clot or bleeding in the brain, a CT scan of the head is done.

• MRI of the head

MRI produces detailed images of organs, soft tissues, bone, and almost all other internal body structures using a high magnetic field, radiofrequency pulses, and a computer.

Cerebrovascular Accident (CVA) Treatment

Ischemic stroke and transient ischemic attack are treated similarly since they are caused by a blood clot or obstruction in the brain.

They may include the following:

Clot-Busting Medications

Blood clots in the brain's arteries can be broken up with thrombolytic medications.

• Tissue plasminogen activator (tPA), also known as Alteplase IV r-tPA, is one such medicine that is regarded as the gold standard in the treatment of ischemic stroke.
• People who receive a tPA injection have a higher chance of recovering from a stroke and a lesser chance of long-term disability.

Mechanical Thrombectomy

This operation works best if it's done within 6 to 24 hours of the onset of the stroke.

Stents

When the artery walls have weakened, a procedure to inflate the restricted artery and reinforce the artery walls with a stent may be performed.

Surgery

In the rare instances that other CVA treatments don’t work, surgery can remove a blood clot and plaque from your arteries.

Risk Factor of 

Cerebrovascular Accident (CVA)

Multiple factors play a role in increasing the risk of stroke. These include:

• Hypercholesterolemia: When a blood artery blockage occurs near the cerebral area, the brain cells die, leading to paralysis
• Consumption of Tobacco and Alcoholic Beverages: These behaviors cause the blood vessel wall to weaken. Smokers' vessel walls are more vulnerable than nonsmokers
• The Concentration of Blood: There is a greater risk of CVA if the hemoglobin level is higher than normal limits
• Degeneration Due to Old Age: This affects the blood vessels as well
• Illegal Drugs: The use of drugs like crack, cocaine, and marijuana can cause a stroke by directly affecting the blood arteries in the brain. Some harm the heart, which can result in a stroke.

Stage (word count depends on the information available for the disease)

Possible Complication of Cerebrovascular Accident (CVA)

After a stroke, patients may continue to have some symptoms and issues.

The limbs become stuck in a given position due to the persistent shortening of a muscle or joint called contracture. Food or fluids can get into the lungs if the patient has a swallowing problem, leading to pneumonia. Urinary tract infections occur due to poor genital hygiene.

Reduced movement may cause the skin of certain body areas to break down due to continual strain causing bedsores.

Blood clots in the legs' veins might form due to restricted mobility following a stroke. Following a CVA, muscle spasticity can cause your muscles to become stiff and contract abnormally, resulting in pain.

CVA-damaged brain cells can cause aberrant electrical activity in the brain, resulting in convulsions.

Preventions of Cerebrovascular Accident (CVA)

Primary Prevention

• Reduce salt intake to no more than 1,500 milligrams each day
• Increase intake of polyunsaturated and monounsaturated fats while avoiding saturated fats
• 4 to 5 cups of fruits and vegetables each day, one dish of fish every two to three weeks, and numerous pieces of nutritious grains and low-fat dairy are all recommended
• Increase your daily physical exercise by at least 30 minutes.

Secondary Prevention

Don't slack off or skip doses if the doctor has recommended medicine to help regulate cholesterol, blood pressure, or diabetes.

For those recovering from a stroke, it's critical to maintain blood pressure, high cholesterol, and diabetes under control by taking all of the medications as prescribed.

Eat a low-fat, whole-foods-based, plant-based diet.

The best cardio and cerebrovascular effects come from getting at least 7 hours of unbroken sleep.

Differential Diagnosis of Cerebrovascular Accident (CVA)

Brain tumors, hemorrhagic stroke, subdural hemorrhage, neurosyphilis, complex or atypical migraine, hypertensive encephalopathy, meningitis, or encephalitis are all possible differential diagnoses for CVA.

Epidemiology

Prevalence: CVA is one of India's most common causes of death and disability. The estimated adjusted prevalence rate of stroke in rural regions is 84-262/100,000, while in urban it is 334-424/100,000.

• Age: Although CVA can occur at any age, the chances of stroke increase every decade after 55 years
• Gender: Men are more commonly affected by CVA than women. But women who smoke, drink, or are on hormonal pills for a long time are at higher risk of CVA
• Race: Strokes are more common in African Americans and Hispanics than Caucasians.

Prognosis

Expected Prognosis

Damage to a brain region induced by a CVA will have an impact on portions of the body controlled by that brain area.

For example, limb weakness or paralysis and loss of speech and facial muscle movement may occur.

CVA survivors have an impairment that makes it difficult to find or keep full-time work. Furthermore, stroke has a significant impact on the quality of life because many people are unable to do daily activities. CVA can also have an emotional impact, including despair, anxiety, and personality shifts.

Natural Progression

Every second is life-saving when it comes to stroke treatment.

The brain ages up to 36 years if a stroke is left untreated for the full 10 hours. The stroke has passed does not mean that the brain damage has stopped. Ischemic strokes take ten hours to develop. That means that the brain damage worsens with every second the therapy is delayed.

Pathophysiology

When blood flow to an area of the brain is disrupted, a CVA develops, resulting in some degree of irreversible neurological impairment. Ischemic (lack of blood and thus oxygen to a part of the brain) and hemorrhagic (bleeding from a burst or leaking blood vessel in the brain) strokes are the two main types of stroke.

Ischemic atherosclerosis, or the formation of fatty plaques lining the blood arteries, is a prevalent cause of narrowing. The blood vessel narrows as the plaques expand in size, and blood flow to the area beyond is restricted. Hemorrhagic strokes occur when a blood artery ruptures, causing brain tissue compression from an enlarging hematoma.