Stroke is defined as a syndrome of rapid onset of the cerebral deficit which is lasts for more than 24 hours or leads to death with no apparent cause other than a vascular one. CVA or cerebrovascular accident is the fancy medical name given to strokes. So both these terms essentially mean the same thing. Thus, there is no specific difference between CVA and Stroke. However, we will discuss here in detail the types of stroke such as ischemic stroke, hemorrhagic stroke, the cause and their clinical features, risk factors, and management etc.
CONTENTS
1. Overview and Key Difference
2. What is Stroke
3. What is CVA
4. Side by Side Comparison – Acute vs Subacute Endocarditis in Tabular Form
5. Summary
What is Stroke?
Stroke is defined as a syndrome of rapid onset of the cerebral deficit which is lasting for more than 24 hours or leading to death with no cause apparent other than a vascular one. In a stroke the blood supply to the brain is compromised and depending on the way this happens, strokes have been classified into two subcategories as ischemic and hemorrhagic strokes.
Ischemic Stroke
An ischemic stroke is the impairment of the blood supply to brain secondary to an obstruction in a cerebral vessel. A vast majority of the strokes are ischemic strokes.
Causes of Ischemic Stroke
- Thrombosis and embolism
Atrial fibrillation and arrhythmias leading to the formation of thrombi and their subsequent embolization is the commonest cause of strokes. Simultaneous infarcts in different vascular territories are a clear indication of a cardiac embolic stroke.
- Hypoperfusion
- Large artery stenosis
- Small vessel disease
Clinical Features of Ischemic Stroke
- There are loss motor control and sensation over different regions of the body depending on the area of the brain that is affected.
- Visual changes and deficits
- Dysarthria
- Loss of consciousness
- Facial Droop
Hemorrhagic Stroke
In a hemorrhagic stroke, the impairment of blood supply to the brain is due to damage to a vessel or vessels. Blood vessels with aneurysms and weak walls are more susceptible to get ruptured and give rise to hemorrhages inside the cranial cavity.
Causes of Hemorrhagic Stroke
- Intracerebral hemorrhages
- Subarachnoid hemorrhages
These hemorrhages can be due to trauma, rupturing of aneurysms, arteriovenous malformations and etc.
Clinical Features of Hemorrhagic Stroke
There will be clinical features similar to those of ischemic hemorrhages. In addition, subarachnoid hemorrhage can give rise to the following set of signs and symptoms also.
- sudden onset of a severe headache
- nausea
- vomiting
- syncope
- photophobia
Risk factors for strokes
- Hypertension
- Chronic smoking
- Sedentary and stressful lifestyle
- Chronic alcoholism
- High cholesterol
- Atrial fibrillation
- Obesity
- Diabetes
- Sleep apnea
- Carotid stenosis
Management of Strokes
- The patient should be immediately admitted to a multidisciplinary care unit.
General measures given below have to be taken,
- Confirm the patency of the airway and continue monitoring it to identify any obstructions in it
- Monitor the blood pressure while providing oxygen via a mask
- Try to identify the source of emboli
- Assess the ability of the patient to swallow
Brain imaging is necessary for the assessment of the degree of damage and the probable cause. CT and MRI are the most appropriate imaging modalities. If the radiographs show the presence of a hemorrhage, avoid giving any drug that can interfere with clotting. If there is no hemorrhage and thrombolysis is not contraindicated start the thrombolytic therapy immediately.
In case of hemorrhages, neurosurgeries are occasionally required to drain the blood that has accumulated inside the cranial cavity and prevent the buildup of an undue pressure that can compress the brain substances.
Fig 01:Stroke
In the long term management of stroke patients, the aforementioned risk factors should be identified, and measures should be taken to minimize the risk of the patient’s life. Antihypertensive therapy and anticoagulant therapy (especially in patients with atrial fibrillation) are two important aspects of the long-term management of stroke patients. Psychotherapy and physiotherapy will be helpful in improving the patient’s quality of life.
What is CVA?
CVA or cerebrovascular accidents is the medical name given to strokes.
What is the Difference Between CVA and Stroke?
- There is no difference between CVA and Stroke. CVA and stroke are synonyms that in general terms mean the appearance of various neurological deficits as a result of the vascular lesions in the brain.
Summary – CVA vs Stroke
Stroke is defined as a syndrome of rapid onset of the cerebral deficit which is lasting for more than 24 hours or leading to death with no cause apparent other than a vascular one. CVA or cerebrovascular accident is the medical name given to strokes. Thus, there is no difference between CVA and Stroke since they both indicate the same thing.
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Reference:
1.Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image courtesy:
1.’Atrial fib stroke’By National Heart Lung and Blood Institute (NIH), (Public Domain) via Commons Wikimedia