Stroke - Cerebrovascular Accident (CVA)

Cerebrovascular Accident (CVA): Overview, Symptoms, Causes & Treatment 

A cerebrovascular accident (CVA)—commonly known as a stroke—occurs when blood flow to part of the brain is suddenly blocked or reduced, depriving it of oxygen and nutrients. This can cause brain cells to die within minutes. Stroke is a medical emergency that requires immediate intervention. Recognising early symptoms like facial drooping, arm weakness, and slurred speech can make a life-saving difference. In this article, you'll learn about the different types of strokes, what causes them, how to identify a stroke quickly, and what treatment and rehabilitation options are available.

What is Cerebrovascular Accident (CVA) or Stroke?

A stroke-or-cerebrovascular-accident-cva occurs when there is a sudden interruption in the blood flow and nutrient supply to a part of your brain. The brain cells do not receive the optimum oxygen and begin to die within minutes. As it is a medical emergency, prompt treatment is crucial.

Usually, the blood flow to the brain stops if there is a blockage or rupture of an artery to the brain. Unless you receive medical attention at the earliest, severe damage to the brain can lead to some long-term disability. The outcome can be fatal, too.

What Are the Different Types of Strokes?

A stroke is a medical emergency that occurs when blood flow to the brain is disrupted, either due to a blockage or a burst blood vessel. This interruption deprives the brain of oxygen and nutrients, leading to potentially severe complications within minutes. Strokes are primarily classified into two main types:

Ischemic Stroke

This is the most common type, accounting for around 87% of all strokes. It occurs when a blood clot or plaque blocks a blood vessel in the brain. Symptoms include sudden weakness (especially on one side), confusion, speech difficulties, vision problems, and loss of balance. Treatment involves clot-busting medications or surgical intervention to restore blood flow.

Types of Ischemic Stroke:

• Thrombotic stroke: Clot forms in a brain artery.
• Embolic stroke: Clot originates elsewhere and travels to the brain.

Hemorrhagic Stroke

This type results from a ruptured blood vessel, causing bleeding in or around the brain. It’s less common but often more severe. Causes include high blood pressure, aneurysms, arteriovenous malformations, or trauma. Treatment focuses on stopping the bleeding and relieving pressure on the brain.

Types of Hemorrhagic Stroke:

• Intraparenchymal: Bleeding inside brain tissue.
• Subarachnoid: Bleeding between the brain and its membrane, often due to aneurysms.

Other Types of Stroke

• Transient Ischemic Attack (TIA): A “mini-stroke” with temporary blockage and no lasting damage, but a serious warning sign.
• Cryptogenic Stroke: Stroke with no identifiable cause after standard evaluation.
• Brainstem Stroke: Affects the brainstem, which controls vital functions—may lead to severe disability or locked-in syndrome.
• Recurrent Stroke: Occurs when a person experiences more than one stroke; risk increases after the first incident.

Symptoms of Cerebrovascular Accident (CVA) or Stroke

The onset of the symptoms of stroke is sudden and quick. Medical attention should be sought immediately if you notice any of these symptoms. 

Common Stroke Symptoms

If you or someone nearby might be having a stroke, note the time symptoms begin. Some stroke treatments are only effective if administered within the first few hours.

Key symptoms to watch for include:

• Trouble speaking and understanding language: A person having a stroke may experience confusion, slurred speech, or difficulty comprehending what others are saying. They may respond inappropriately or struggle to form words.
• Numbness, weakness, or paralysis—especially on one side of the body: This can affect the face, arm, or leg. One tell-tale sign is an inability to lift both arms—if one drifts downward, it may indicate a stroke. The same applies to facial drooping when smiling.
• Vision problems in one or both eyes: Sudden blurred, darkened, or double vision may occur. In some cases, there may be a complete loss of vision in one eye.
• Sudden, severe headache: A strong headache with no known cause—often accompanied by vomiting, dizziness, or reduced consciousness—can signal a stroke, especially if it begins abruptly.
• Trouble walking or maintaining balance: The person may stumble, lose coordination, or feel unsteady. They may also experience dizziness or difficulty controlling movements.

Additional Warning Signs

In addition to the major symptoms above, watch for these possible signs:

• Difficulty swallowing (dysphagia): Stroke can impair the muscles involved in swallowing, increasing the risk of choking or aspiration.
• Sudden behavioural or mood changes: Some individuals may appear confused, irritable, withdrawn, or unusually emotional.
• Unexplained fatigue or drowsiness: A sudden onset of tiredness or a tendency to doze off could indicate a drop in brain function due to disrupted blood flow.
• Vision disturbances: Apart from blurring, some people may see flashing lights, shadows, or visual field losses depending on which part of the brain is affected.

How to Identify a Stroke with the FAST Method 

To quickly recognise a stroke, use the FAST method:

• Face: Drooping of any one side of the face.
• Arm: The arm drifts down on holding it outwards.
• Speech: Abnormal or slurred speech.
• Time: Call the emergency now and rush to the hospital immediately.

Causes of Stroke or Cerebrovascular Accident (CVA)

Stroke can occur due to two primary reasons: blocked arteries or ruptured blood vessels in the brain. In some cases, the disruption in blood flow is temporary, leading to a transient ischemic attack (TIA), which resolves without lasting damage.

Ischemic Stroke

This is the most common type of stroke, caused by a blockage in a blood vessel supplying the brain. The blockage may result from:

• Fatty deposits (atherosclerosis) that narrow the arteries.
• Blood clots or debris that travel from the heart or other parts of the body and lodge in brain arteries.

This interruption in blood flow, called ischemia, reduces oxygen supply to brain tissue. Emerging research suggests that infections like COVID-19 may also increase the risk of ischemic stroke, though more evidence is needed.

Hemorrhagic Stroke

A hemorrhagic stroke occurs when a weakened blood vessel in the brain ruptures or leaks, causing bleeding within or around the brain. Common causes include:

• Uncontrolled high blood pressure
• Excessive use of blood thinners (anticoagulants)
• Aneurysms – weak, bulging areas in vessel walls
• Head injuries from accidents or trauma
• Cerebral amyloid angiopathy – protein buildup in vessel walls that leads to rupture
• Conversion of ischemic stroke into a bleed (hemorrhagic transformation)
• Rupture of arteriovenous malformations (AVMs) – abnormal tangles of blood vessels

Transient Ischemic Attack (TIA)

A TIA, often called a “mini-stroke,” is a short-term blockage of blood flow to the brain, typically lasting only a few minutes. It’s caused by:

Temporary clots or fatty deposits that partially block blood vessels in the brain. While TIAs do not cause permanent damage, they are serious warning signs. Anyone experiencing TIA symptoms should seek immediate emergency care, as TIAs significantly raise the risk of future strokes.

How Are Strokes Diagnosed?

To accurately diagnose a stroke, your healthcare provider will:

Ask about your symptoms and medical history: They will gather detailed information about your recent symptoms, any prior strokes, and your overall health history.

Perform a physical exam, which includes checking:

• Your mental alertness and cognitive functions.
• Your coordination and balance.
• Numbness or weakness in your face, arms, or legs.
• Any difficulties with speech or vision.

Conduct various tests, which may include:

• Diagnostic Imaging: CT scans or MRIs to determine the type and severity of the stroke.
• Heart Tests: EKGs and echocardiograms to identify heart conditions or blood clots that may have caused the stroke.

Emergency Response to Stroke

Prompt action during a stroke can significantly impact the person's recovery and outcome. Knowing what to do can save lives and reduce long-term damage.

What to Do When Someone Is Having a Stroke

Recognising the signs of a stroke and acting quickly is crucial. Here are the steps you should take:

• Recognise stroke symptoms: sudden numbness or weakness on one side, confusion, speech trouble, vision issues, dizziness, loss of balance, and severe headache.
• Use the ‘FAST’ Method: Ask the person to smile and check if one side of the face droops. Ask them to raise both arms and see if one arm drifts downward or is unable to rise. You can check for slurred words by asking the person to repeat a simple phrase or strange speech. If you observe any of these signs, call emergency services immediately.

Importance of Quick Response

Acting quickly during a stroke is vital. The faster a person receives medical treatment, the better their chances of recovery and reducing long-term disability. Every minute counts, as time lost means more brain damage.

Calling Emergency Services

• Dial Emergency Services: Call 102 immediately or your nearest. Do not attempt to drive the person to the hospital; emergency responders can start treatment en route.
• Provide Clear Information: Clearly describe the person's symptoms, your location, and any known medical history to the dispatcher. Follow their instructions carefully.
• Stay with the Person: Keep them calm and stay with them until help arrives. Note the time when symptoms first appeared, as this is important for medical personnel.

Stroke Treatment Overview

Treatment depends on the type of stroke:

• Ischemic Stroke: Caused by blocked arteries.
• Hemorrhagic Stroke: Caused by bleeding in the brain.
• TIA (Transient Ischemic Attack): Temporary blockage; warning sign for future strokes.

Ischemic Stroke Treatment

Emergency Treatments

• IV thrombolytics (TPA): Given within 3–4.5 hours to dissolve clots.
• Endovascular therapy:
  
  • Direct TPA delivery via catheter to the clot site.
  • Stent retriever to remove large clots.

Preventive Procedures

• Carotid endarterectomy: Removes plaque from neck arteries.
• Angioplasty + stenting: Widens narrowed arteries with a balloon and supports with a stent.

Hemorrhagic Stroke Treatment

Emergency Measures

• Reverse blood thinners.
• Lower brain pressure and blood pressure.
• Prevent seizures and vessel spasms.

Surgical Options

• Clipping: Clamp placed on an aneurysm.
• Coiling: Coils inserted to block blood flow into aneurysm.
• AVM removal: Surgically remove abnormal vessel tangles if accessible.
• Stereotactic radiosurgery: Focused radiation for vessel repair (non-invasive).

Stroke Recovery & Rehabilitation

Begins in the hospital and continues post-discharge. Focuses on regaining movement, speech, and independence.

Rehab Settings

• Inpatient rehab units
• Skilled nursing facilities
• Outpatient centers or home-based care

Recovery Team

• Neurologist
• Physiatrist
• Rehab nurses & therapists (physical, occupational, speech)
• Dietitian, psychologist, social worker, and chaplain

Every recovery is different and tailored based on stroke severity, location, age, and support system.

Who is at Risk for Stroke 

Certain factors elevate your risk of experiencing a stroke. 

• Diabetes, along with fluctuations in blood sugar level.
• High blood pressure is always the primary risk factor for stroke.
• Family history of TIA or stroke-or-cerebrovascular-accident-cva. Heart diseases like atrial fibrillation can cause blood clots.
• Ageing triggers stroke as the arteria wall becomes weaker or hardens with age. 
• Smoking damages the blood vessels and shoots up blood pressure. 
• High cholesterol level
• Regular consumption of alcohol and illegal drugs.
• Unhealthy diet
• Obesity
• Absence of regular physical activities. 

The Role of Physiotherapy in Stroke Recovery

Physiotherapy helps restore movement and functionality post-stroke. For CVA patients, it assists in:

• Regaining strength and balance
• Preventing complications like stiffness or muscle wasting
• Improving mobility and reducing fall risk
• Enhancing independence and quality of life

How to Prevent Stroke or CVA

By now, you know the risk factors that increase the possibility of suffering from a stroke. However, there are various measures to prevent the condition. So here are the ways that will help to reduce the risk.

• Maintain normal blood pressure levels. If necessary, follow medication. 
• Refrain from regular drinking, smoking, and consumption of harmful drugs.
• Control blood sugar level
• Maintain healthy body weight.
• Include vegetables and fruits in the diet plan.
• Exercise regularly. 
• Limit the inclusion of saturated fats and cholesterol in the diet.
• Regular check-ups with healthcare providers can help monitor risk factors and implement preventive measures.

The healthcare provider may prescribe medicines for preventing stroke-or-cerebrovascular-accident-cva if the doctor knows that you are at risk. The blood-thinning medication works the best to prevent clot formation. ‍

Related Conditions to Cerebrovascular Accident (CVA) or Stroke

Recovery from a major stroke or CVA will be a long process as the condition can have several effects. Some of these effects are even irreversible. The related conditions include

• Changes in the senses
• Spasticity
• Vision problems with partial or permanent loss of vision
• Behavioural changes
• Clinical depression
• Fatigue
• Perception, attention, and memory problems.
• Weakness and paralysis

Empower Your Health Journey with Physiotattva

Strokes can be life-threatening, but early recognition and treatment can save lives and improve outcomes. By understanding the symptoms, causes, and treatments, you can better protect yourself and your loved ones. Prioritise regular health check-ups, maintain a healthy lifestyle and stay informed about the latest stroke prevention strategies. Taking a proactive approach to your health can significantly reduce your stroke risk.

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery. 

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.