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Cerebral Vascular Accident: "The Stroke"

Updated on January 4, 2014

Cerebral Vascular Accident

A cerebral vascular accident (CVA) often referred to by people as a "stroke" can happen as a complication of other underlying health conditions. Simply put, tissue death in the brain occurs because neurons die. CVA's can occur in people of all ages and walks of life. You may not of known this, however more than one type of cerebral vascular accident can occur in individuals.

Women with signs of a CVA

Ischemic CVA

Ischemic strokes make up 85% of all strokes. Within minutes of ischemia, known as tissue death related lack of rich blood oxygen, neurons or "brain cells" under cell death. When ischemia happens a chain of events occurs including inflammation at the site of the stroke resulting from infiltration of leukocytes which can increase damage.

The area of the necrosis (cellular death) determines what functions will be affected in a person. This can result in a multitude of symptoms including numbness, weakness, confusion, changes in mental status, trouble speaking or understanding speech, visual disturbances, balance issues, and sudden headaches.

Risk factors include:

  • Advanced age
  • Male gender
  • African American
  • Hypertension ~ "High blood pressure"
  • Atrial fibrillation
  • Carotid stenosis ~ "Narrowing of the carotid arteries"
  • Hyperlipidemia ~ "High cholesterol"
  • Obesity
  • Smoking
  • Diabetes
  • Excessive alcohol consumption


Thrombotic CVA

Approximately 45% of individuals who have ischemic CVA's are caused by a Thrombotic occurrence (Smeltzer, et al.). A thrombus (thrombotic) event occurs when things such as plaques break off and get lodged in a small vessel in the brain. A thrombus can also be made up from a blood clot.

Large artery thrombotic strokes are caused by atherosclerotic plaques that grow, eventually rupture and form a thrombus. This very condition is the reason your physicians may continuously tell you that you need to have your cholesterol regulated to prevent buildup of plaques in your blood vessels.

CVA associated with Atrial Fibrillation

Source

Embolic CVA

An embolic CVA or "stroke" is often caused by an "emboli" such as infection, air, fat, however are usually caused by blood clots hat form in the heart known as cardiogenic emboli. Emboli can also form in the carotid arteries and break loose, blocking arteries int he brain.

Cardiogenic emboli are generally associated with atrial fibrillation, or prosthetic valves, where blood forms clots and break loose, eventually stopping in the cerebral vasculature. This most often occurs in the left middle cerebral artery.

Many times physicians and other health care professionals with start patients on anticoagulant therapies such as Warfarin to help prevent this type of CVA from occurring.

Diagram of two types of Strokes

Source

TIA

  • Often referred to as "Mini Strokes"
  • Neurological deficit "stroke symptoms" that resolve within 1 to 24 hrs
  • Abrupt loss of visual sensory and motor functions
  • Causes Temporary ischemia in the brain
  • May serve as a "warning sign of an impending stroke"

Hemorrhagic CVA

A hemorrhagic CVA "stroke" occurs in 15% of all strokes and is caused by vessels breaking and bleeding into surrounding brain tissue. Often spontaneous rupture of small vessels occur because of uncontrolled high blood pressure leading to 80% of hemorrhagic stroke occurrence.

Risk Factors for Hemorrhagic CVA

  • Advanced age
  • Male gender
  • African American
  • Hypertension ~ "High blood pressure"
  • Obesity
  • Smoking
  • Diabetes
  • Head trauma

Diagnostic Tests, Medications, & Procedures

 
 
 
CT scan of the Head
12 Lead EKG
Carotid Ultrasound
Complete Blood Count
PT/ INR
Completed Metabolic Panel
Coumadin
Heparin
TPA therapy
Asprin
Carotid endarectomy
Oxygen therapy

What is a Stroke by Dr. Shipley

Source

Bio

This article was written by James Constanzer, registered nurse and owner of VitalLifeSenior.com an online retail store for senior that provide them and their families and caregivers with the best medical supplies, mobility equipment, vitamins and supplements they need to maintain a healthy, independent lifestyle.

References

American Heart Association/American Stroke Association. Guidelines for the early management of adults with ischemic stroke. (2007). Stroke. AHA journal, 38, 1655-1711. doi: 10.1161/​STROKEAHA.107.181486

Deglin, J., & Vallerand, A. (2009). Davis’s drug guide for nurses (11th ed.). Philadelphia, PA: F.A. Davis Company.

Huether, S.E. & McCance, K.L. (2008). Understanding pathophysiology (4th ed.). St. Louis, MO: Mosby Elsevier.

Irosh, S. (2012, May 6). Stroke [Web log post]. Retrieved from http://fine4fit.blogspot.com/2012/05/stroke.html

Karch, A. (2008). Focus on nursing pharmacology (4th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby's guide to physical examination (7th ed.). St. Louis, MO: Mosby Elsevier.

Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2008). Brunner & Suddarth’s textbook of medical- surgical nursing (11th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.

Woodruff, T. M., Thundyil, J., Sung-Chun, T., Sobey, C. G., Taylor, S. M., & Arumugam, T. V. (2011). Pathophysiology, treatment, and animal and cellular models of human ischemic stroke. Molecular Neurodegeneration, 6(1), 11-29. doi:10.1186/1750-1326-6-11

Though the author of this information is a licensed nurse, the information provided above is FOR EDUCATIONAL USE ONLY, and DOES NOT CONSTITUTE MEDICAL ADVICE/OPINION, is not meant to diagnose or treat any illness or disease, and is not a substitute for the medical advice of your (or your loved one's) primary care physician or other medical professional. While striving to be factual and exact, no warranties are made with regards to the accuracy of the information provided above. You are always advised to talk with your (or your loved one's) doctor about any health concerns that you have and about any of the information provided above. Sole reliance on the information provided above is not advised and would be solely at your own risk and liability.

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