Stroke, CVA (cerebrovascular accident), CVI (cerebrovascular insult), Brain Attack
Ischemic stroke, also known as CVA (cerebrovascular accident) or CVI (cerebrovascular insult) or Brain Attack is defined as an interruption of blood flow within one of the brain feeding arteries. Thus the effected brain areas are losing their function and if not treated in time, the nerve cells are dying. Depending on the affected area a stroke can have various clinical signs.
Causes & Risk factors
Most common causes of an ischemic stroke or CVA (cerebrovascular accident) are arteriosclerosis and cardiac embolism following atrial fibrillation. Other causes are vasculitis, arterial dissection or diseases causing hyper-coagulation (blot clotting). There are certain risk factors associated with ischemic stroke or CVA (cerebrovascular accident): age over 60, male gender, Hypertension, Atrial fibrillation, Diabetes mellitus, Dyslipidemia, Cigarette smoking, Oral contraceptive, Migraines.
Symptoms of an ischemic stroke or CVA (cerebrovascular accident) are depending on the affected area of the brain. Often symptoms occur suddenly and are affecting one side. It could be sudden loss of vision, weakness of a limb (paresis), numbness or loss of sensory, problems speaking or swallowing, loss of consciousness, headache, nausea and others. If the symptoms fully recover, the neurologist speaks about an TIA, transient ischemic attack.
Ischemic stroke or CVA (cerebrovascular accident) is a clinical diagnosis. However, the following tests need to be performed. CT scan or CT angiography, MRI, ECG (Electrocardiography), ECD (Extracranial Duplex Sonography), TCD (Transcranial Duplex Sonography), Echocardiography, blood examinations.
The most effective treatment is the prevention of an Ischemic stroke or CVA (cerebrovascular accident). This means reducing the risk factors. To evaluate the risk of Carotid artery stenosis a neurologist can perform a ECD (Extracranial Duplex Sonography), TCD (Transcranial Duplex Sonography). Depending on the findings patients can benefit from interventional therapy, such as carotid endarterectomy. Hypertension, Atrial fibrillation, Diabetes mellitus, Dyslipidemia must be monitored closely and treated correctly. Moreover life stile changes should include: Diet, sports, reducing smoking.
In case a stroke or CVA (cerebrovascular accident) happened, time is the most important factor. Patients must be admitted and treated in a hospital within 3h. First line therapy is i.v. thrombolysis in combination with other medication.
After a stroke or CVA (cerebrovascular accident) happened, patients must take medicine to prevent a second event. This medicine keeps the blood from clotting. Moreover early rehabilitation is determining the recovery. The rehabilitation must be comprehensive and include physiotherapy, speech therapy, occupational therapy and psychology.