CEREBRO VASCULAR ACCIDENT

DEFINITION:
Cerebro Vascular Accident is defined as sudden loss of functioning
resulting from disruption of the blood supply to a part of brain.
CAUSES:
Large Artery Thrombolic Strokes: Caused by arthersclerotic plaques in
the large blood vessels in the brain produce infection.
Small Penetrating Thrombolic Strokes or Lacunar Strokes
Cardiogenic Embolic Strokes: Emboli orginate from the heart circulate to
the cerebral vasculatre
Cryptogenic Strokes: Not known cause.
Other Causes: Illicit drug use, coagulopathies, migraine, spontaneous
dissection of carotid arteries.
RISK FACTORS:

Heart Diseases
Hypercoagulability
Oral Contraceptive use
Physical inactivity
Sickle Cell diseases

PATHOPHYSIOLOGY:
CLINICAL MANIFESTATIONS:

 Neurological deficit depending on the location of the lesion, size of the

area of infarction.
Numbness or Weakness of face, arm, leg.
Confusion or Change in mental status.
Trouble speaking
Visual disturbances
Difficulty in walking
Dizziness
Loss of balance
Sudden severe headache.

Motor Loss:
Loss of voluntary control over motor movements due to lesion in upper
motor neuron lesion.
Hemiplegia (Paralysis of one side of the body)
Hemiparesis (Weakness of one side of the body)
Communication Loss:
Dysarthia (Difficulty in speaking)
Dysphasia or Aphasia (Impaired speech)
Apraxia (Inability to perform a previously learned action)
Perceptual Disturbances:
Hemianopsia (Loss of half of the visual field)
Sensory Loss:
Agnosia (Inability to recognize the familiar object)
DIAGNOSTIC FEATURES:

History Collection
Physical Examination
Computed Tomography
Electro Cardio Gram
Carotid Ultrasound
Cerebral Angiography
Echo
Magnetic Resonance Imaging

PREVENTION:

Identifying the risk group and educate them.

Low dose aspirin may lower than risk of stroke
Modifiable risk factors and treatment for risk factors.
Patient has to identify the Transient Ischemic Attack (TIA It is
neurologic deficit lasting less than 24 hrs manifested by sudden loss of
motor, sensory, visual function due to temporary ischemia to specific
region of brain.)

MEDICAL MANAGEMENT:
For cardio-embolic treat it with (Coumadin) warfarin sodium.
Platelet inhibiting medication such as aspirin, clopidogel, triclopidine will
decrease the incidence of cerebral infarction.
3-hydroxy 2-methyl glutaryl co-enzyme A reducatase inhibitors reduce

the coronary events and stroke.

After the acute stroke period antihypertension medication is used to
reduce the blood pressure and prevents further attack.