Define cerebrovascular accident; describe the pathophysiology of a cerebrovascular accident; outline the clinical features of a cerebrovascular accident; list the investigations needed for diagnosing

A cerebrovascular accident (CVA), commonly known as a stroke, is a sudden interruption in the blood supply to the brain, leading to a lack of oxygen and nutrients to brain tissue. This can result in damage to brain cells and potentially permanent neurological deficits.

The pathophysiology of a cerebrovascular accident can be classified into two main types: ischemic stroke and hemorrhagic stroke. Ischemic strokes occur when a blood clot blocks a blood vessel in the brain, cutting off blood flow to a specific area. Hemorrhagic strokes, on the other hand, occur when a blood vessel in the brain ruptures, causing bleeding into the surrounding brain tissue.

The clinical features of a cerebrovascular accident can vary depending on the location and extent of the brain damage. Common symptoms include sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, sudden severe headache, dizziness, loss of balance or coordination, and vision changes.

To diagnose a cerebrovascular accident, a healthcare provider may perform a physical examination, review the patient's medical history, and order various investigations. These investigations may include imaging tests such as a CT scan or MRI to visualize the brain and identify any areas of damage, blood tests to assess for risk factors such as high cholesterol or diabetes, and an electrocardiogram (ECG) to evaluate heart function. Additional tests may be done to determine the underlying cause of the stroke, such as an ultrasound of the carotid arteries or a transesophageal echocardiogram.

Definition of Cerebrovascular Accident (CVA)

A cerebrovascular accident (CVA), also known as a stroke, is a sudden interruption of blood flow to the brain. This can occur due to a blockage (ischemic stroke) or a rupture (hemorrhagic stroke).

Pathophysiology of a Cerebrovascular Accident

Ischemic Stroke:
- Thrombus formation in an artery supplying the brain (thromboembolic stroke)
- Emboli from other parts of the body (atherosclerotic plaque, heart thrombus)
- Vasospasm (narrowing of blood vessels)

Hemorrhagic Stroke:
- Rupture of a weakened blood vessel (aneurysm, arteriovenous malformation)
- Hypertension
- Head trauma

Clinical Features of a Cerebrovascular Accident

Symptoms vary depending on the location and severity of the stroke, but may include:

- Sudden onset of weakness or numbness on one side of the body
- Difficulty speaking or understanding speech
- Vision problems or blindness
- Headache (especially sudden onset and severe)
- Dizziness or loss of balance
- Confusion or memory problems

Investigations for Diagnosing a Cerebrovascular Accident

- Computed tomography (CT) scan: Provides images of the brain to detect bleeding or structural abnormalities.
- Magnetic resonance imaging (MRI): Offers more detailed images of the brain, including areas of ischemia or infarction.
- Carotid duplex ultrasound: Evaluates the carotid arteries for narrowing or plaques.
- Transcranial Doppler ultrasound: Measures blood flow in the brain arteries.
- Electroencephalography (EEG): Records electrical activity in the brain to detect abnormal patterns.
- Echocardiogram: Examines the heart for potential sources of emboli.
- Blood tests: May reveal signs of infection, disorders, or risk factors for stroke.
- Angiography: Involves injecting contrast dye into blood vessels to visualize them and look for abnormalities.