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Cerebrovascular Accident

A cerebrovascular accident (CVA), or stroke, occurs when blood flow to a part of the brain is stopped either by a blockage or by bleeding on the brain or in the surrounding membranes. When a cerebrovascular accident happens, an area of the brain begins to die due to a lack of oxygen and the nutrients it needs.

Stroke is the third most common cause of death in western countries and is the principal cause of disability in adults since it frequently leaves important neurologic sequelae (speech, motor problems…)

There are two types of cerebral attacks or cerebrovascular attacks: ischemic and hemorrhagic. The majority of cerebrovascular attacks are ischemic. They occur due to a gradual formation of atherosclerosis (narrowing) of the arteries that supply blood to the brain, or when a blood clot blocks a cerebral artery (frequently caused by cardiac arrhythmias such as atrial fibrillation).

Symptoms

The symptoms of a stroke usually appear suddenly. They are

  • numbness or paralysis, tingling or weakness in the face, leg, or arm, most likely on just one side of the body
  • sudden confusion or difficulty speaking or understanding others who are speaking
  • blurred or darkened vision in one or both eyes
  • sudden difficulty walking, dizziness or loss of balance and coordination
  • a sudden headache, especially of unknown cause

Prevention

Many cerebrovascular attacks (strokes) could be avoided if measures by taking to help prevent them. However, some of the risk factors are out of our control such as:

  • Age (older than 55)
  • Sex (More women than men have a stroke)
  • Race (AfroAmerican)
  • Family history of cerebrovascular attacks
  • Previous CVA or TIA
  • Fibromuscular displasia (FMD)
  • Patent foramen ovale (PFO)

 

If you have one or more of the following risk factors, it is important to make changes in your life style and take advantage of some treatments to diminish the risk.

  • Prevent and treat high blood pressure. High blood pressure is the principal cause of a stroke. The optimum blood pressure reading is 120/80 mmHg or lower.
  • Reduce salt (sodium) intake.
  • Smoking. Smoking doubles the risk of having a stroke.
  • Reduce alcohol intake.
  • High cholesterol. The total level of cholesterol should not be higher than 200.
  • Diabetes. A correct control of your diabetes can reduce the risk of a stroke.
  • Increase your cognitive reserve. Read, learn a foreign language, learn new skills, keep a journal or do manual tasks are some of the activities that make our brain more resistant to the possible after effects of an ictus. This is what is meant by cognitive reserve. Doing these things will not prevent a stroke but they will minimize the after effects and improve recuperation significantly.
  • Practice healthy life habits: Exercise regularly, eat a balanced diet, low in salt and fats.
  • Know the alarm signs.

 

As for hemorrhagic cerebrovascular attacks, there are certain etiologies such as congenital malformations that make the illness difficult to prevent since there are no effective screening measures.


The treatment to prevent cerebrovascular attacks gives optimum results in those persons who have more probabilities of a recurring attack.

Gene or region studied

  • 12p13.33
  • PALLD
  • SERPINI1
  • ABCG2
  • CYBA
  • 18q11.2
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