Speaking of Health – Cerebrovascular Accident

By Gilda Morales, ANP, DC

Today’s column deals with a disease that everyone is afraid of—stroke or cerebrovascular accident or CVA.  There are basically two different types of strokes, thrombotic or ischemic, which occurs when there is an occlusion of one of the arteries in the brain, or hemorrhagic or a bleed in a weak area in the brain.  The ischemic type is much more common, making up about 87% of all strokes, with hemorrhagic making up the remaining 13%.

There is a third type, transient ischemic attacks, TIAs or mini-strokes that will result in neurological symptoms that are not permanent.  Men are more likely than women to suffer a stroke and the risk of stroke increases with age.  Other lifestyle choices that can increase the risk are smoking, uncontrolled high blood pressure, cocaine use, amphetamine use, high cholesterol, and a sedentary lifestyle.

The symptoms of a stroke are unique and usually include weakness of the arms or legs, facial weakness or drooping, difficulty with speech or swallowing, dizziness, loss of vision, decreased consciousness, vomiting, and severe headache.  It is important to get to a hospital at the first sign of possible stroke because there is a short window where the most improvement can be made.  In the case of an ischemic stroke, IV treatment using a “clot-buster” has to be done within three to four and one half hours of the stroke.  Unfortunately, there are several conditions that preclude using the clot-buster including head trauma or a prior stroke within 3 months, heart attack within three months, gastric ulcer hemorrhage within 21 days, major surgery within 14 days and elevated blood pressure greater than 185/110.  Other exclusions include age greater than 80 years of age, use of Coumadin or other blood thinners and a history of stroke and diabetes.

Rehab after a stroke to address any weaknesses or deficits should be done as soon as possible afterward to regain the most improvement.  However, the best treatment is to avoid having a stroke in the first place by controlling your blood pressure, keeping your cholesterol low, quit smoking and avoid using stimulant drugs like cocaine and amphetamines.