Cerebrovascular Accidents Assignment

Discuss the pathophysiology of cerebrovascular accidents (CVAs)—thrombotic, embolic, hemorrhagic, and lacunar—their incidence and prevalence, clinical manifestations, evaluation, and treatment.Cerebrovascular Accidents Assignment

Incidence and Prevalence of Cerebrovascular Accidents (CVAs)

Cerebrovascular accident is a medical term which is used to define a stroke. According to the World Health Organization, it is the 4^th killer and second leading cause of disability and dementia among adults in the United States. As a highly prevalent condition, the global impact it even more pronounced as compared to how it is in the US (Hill et al., 2019).  In the adult population in the United States, the prevalence of cerebrovascular accidents is 30% and this translates to close to 7 million people. Annually, approximately 800,000 secondary and primary strokes occur in the US. However, the majority are primary CVAs where 85% are ischemic infarctions, 4% hemorrhage in the subarachnoid space and 11% primary hemorrhage (Hill et al., 2019). The prevalence is much higher among Asians, Latin Americans and Africans.Cerebrovascular Accidents Assignment

Pathophysiology of Cerebrovascular Accidents (CVAs)

             A CVA occurs when a blood vessel is blocked by a blood clot and prevents oxygen and blood from reaching the brain. It can also occur as a result of excessive hemorrhage from a ruptured blood vessel preventing blood from reaching the brain (Hill et al., 2019).

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Clinical Manifestations

            The signs and symptoms of a patient with cerebrovascular accident may vary depending on the specific brain region it occurs and an individual. Even when nor severe, the symptoms are usually of sudden onset and tend to worsen gradually. The most common signs and symptoms include dizziness, difficulty walking, slurred speech, blurred vision, loss of coordination and balance, headaches associated with vomiting and nausea (Hill et al., 2019).

Evaluation

            In order to diagnose a CVA, clinicians are required to conduct a comprehensive physical exam which will help to ascertain a patient’s reflexes, speech, sense, strength, and vision. A physical exam will also help to check for bruits, an indication of abnormal blood flow. Preferred diagnostic tests include an electrocardiogram which helps to determine an abnormal heart rhythm and a brain MRI scan which is comprehensive and more sensitive in detecting a CVA (Hill et al., 2019). Cerebrovascular Accidents Assignment

Treatment

            Treatment is highly dependent on the CVA that a patient has had. For instance, in hemorrhagic CVAs, treatment aims at controlling bleeding while in ischemic CVAs, treatment aims at restoring the flow of blood. Therefore, in the management of ischemic CVAs, blood thinners such as aspirin can be prescribed. For hemorrhagic CVAs, medications which lower pressure in the brain as a result of bleeding can be prescribed (Hill et al., 2019).

References

Hill, B. J., Kowalik, C. G., Cohn, J. A., & Dmochowski, R. R. (2019). Cerebrovascular Accidents. In Neurourology (pp. 495-498). Springer, Dordrecht.Cerebrovascular Accidents Assignment