Stroke (Cerebrovascular Accident – CVA)

A stroke is a “brain attack”: It occurs when blood flow to the brain is cut off, causing death or brain damage. Often referred to as a disease, a stroke is really the result of cardiovascular disease. There are basically two different kinds of strokes: Ischemic strokes, which account for 88 percent of all strokes, are caused by clots in the artery; hemorrhagic (or bleeding) strokes are caused by ruptured blood vessels.

Ischemic Stroke

Ischemic Stroke

Hemorrhagic Stroke

Hemorrhagic Stroke

A stroke is a dreadful event because if any part of the brain doesn’t get what it needs in the way of oxygen or nutrients, it begins to starve to death – immediately. And the area of the body being served by that part of the brain suffers. If, for example, the speech area of the brain is deprived of blood, then the person develops speech problems. If the stroke occurs toward the back of the brain, then some disability involving vision is likely to result. A serious stroke frequently puts the victim into a long-term care facility, a milder stroke may require time and therapy before the person can resume even the most ordinary activities. Know the warning signs of stroke. If you or someone you know show signs of a stroke, then call 911 or your hospital emergency immediately.

Signs of a stroke

  • sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • sudden confusion, trouble speaking, or understanding
  • sudden trouble seeing in one or both eyes
  • sudden trouble walking, dizziness, loss of balance, or coordination
  • sudden, severe headache with no known cause
  If you suspect a stroke, you can do a quick test by asking the person if he/she can:
  • smile
  • raise both arms and keep them up
  • speak a simple sentence coherently

Diagnosis

Your doctor may be able to make a preliminary diagnosis based on your symptoms, a physical and neurological examination, and your medical history, but to be sure, your doctor will also probably run some tests, which may include at least one of the following:
  • an imaging test: to provide a picture of the brain similar to X-rays (e.g., computed tomography (CT) scan, magnetic resonance imaging (MRI)).
  • an electrical test: to show the electrical impulses of the brain (e.g., electroencephalogram (EEG)).
  • blood flow tests: to reveal any problem that may cause changes in blood flow to the brain (e.g., ultrasound, arteriography).

Treatment

Brain damage begins from the moment the stroke occurs so the sooner the victim receives medical treatment the better. For full recovery from an ischemic stroke, special medications should be taken within 3 hours. Most people who’ve had a stroke require some kind of rehabilitation to help in their recovery. Happily, the brain can remodel and reorganize itself after a stroke, but it needs help. Almost a quarter of stroke survivors experience another stroke within 5 years and the risk of severe disability and death increases with each stroke. Proper medical management, which may include anti-stroke medication such as antiplatelet agents (e.g. Aspirin®), and establishing healthy changes to your lifestyle can reduce the risk of a recurrent stroke.

Stroke and transient ischemic attacks

The same things that cause a stroke can also cause a transient ischemic attack (TIA)-plus the symptoms for both are the same. What distinguishes a TIA from a stroke is that the obstruction of blood flow is only temporary and the effects last less than 24 hours, sometimes less than 30 minutes. Although a TIA causes no permanent damage to the brain, it is a warning sign that a stroke may occur. Recent findings indicate that almost 20 percent of people who have a TIA or minor stroke, go on to have a major stroke within 3 months. You could say that having a TIA gives that person the chance to reduce his or her risk of a stroke.

Strokes are preventable

While you can’t change certain things about yourself, such as family history, there are some things you can do to prevent yourself from having a stroke:
  • Don’t smoke, and avoid second-hand smoke.
  • If you have diabetes, make sure you keep it under control with diet and medication.
  • Keep blood levels of cholesterol within healthy limits; avoid saturated fats.
  • If you’re overweight, lose weight.
  • If you have blood pressure that’s too high, reduce it.
  • If you’re out of shape, get physically active.
  • If you drink too much, drink less; moderate use of alcohol is recommended.

Did you know that…

  • one quarter of Canadians who have a stroke are under 65 years of age?
  • although more men have strokes, more women die from stroke?
  • in most cases, strokes cause no pain?
  • people with high blood pressure are 4 to 6 times more likely to have a stroke?
  • people with an irregular heart beat (e.g. atrial fibrillation) or other heart disease are 6 times more likely to have a stroke?
  • people with a family history of stroke are 5 times more likely to have a stroke themselves?
  • about 20 percent of people who have strokes also have diabetes?
  • first-generation Black Canadians from Africa have a greater risk of stroke than the rest of the population?

For more information or for support

The Heart and Stroke Foundation of Canada www.heartandstroke.com