From the Guidelines
CVA, or Cerebrovascular Accident, is a medical term for a stroke, which occurs when blood flow to part of the brain is interrupted, either by a blockage or a rupture in a blood vessel, and is characterized by acute loss of neurological function with residual symptoms at least 24 hours after onset, as defined by the American College of Cardiology/American Heart Association task force on clinical data standards 1.
Definition and Diagnosis
A CVA is diagnosed based on a documented history of stroke or cerebrovascular accident with acute loss of neurological function caused by an ischemic or hemorrhagic event, and the diagnosis is confirmed by CT, MRI scan, or cerebral angiography 1. The most likely etiologies of CVA include:
- Larger-artery disease (e.g., carotid)
- Small-artery disease (lacunar)
- Embolism
- Other, specify
- Not specified The current level of functioning is assessed via categories including:
- Complete/near-complete recovery
- Mild to moderate deficit
- Severe deficit
Risk Factors and Prevention
Risk factors for CVA include high blood pressure, smoking, diabetes, high cholesterol, heart disease, and age, and prevention involves managing these risk factors through medication, lifestyle changes, and regular medical check-ups 1.
Treatment and Management
Immediate medical attention is crucial for stroke treatment, as treatments like tissue plasminogen activator (tPA) for ischemic strokes must be administered within hours of symptom onset, and the FAST acronym (Face drooping, Arm weakness, Speech difficulties, Time to call emergency services) helps identify stroke symptoms quickly 1.
Recent Guidelines
The American College of Radiology Appropriateness Criteria provide evidence-based guidelines for the evaluation of cerebrovascular disease, and recommend the use of imaging modalities such as CT and MRI in the evaluation of cerebrovascular disease 1.
From the Research
Definition of CVA
- CVA stands for Cerebrovascular Accident, which is a condition where the blood supply to the brain is interrupted, leading to tissue damage and loss of brain function 2.
- It is also commonly referred to as a stroke, which is a clinically defined syndrome of acute, focal neurological deficit attributed to vascular injury (infarction, haemorrhage) of the central nervous system 2.
Types of CVA
- There are two main types of CVA: ischemic and hemorrhagic 2.
- Ischemic CVA occurs when a blood vessel in the brain becomes blocked, reducing blood flow to the brain 2.
- Hemorrhagic CVA occurs when a blood vessel in the brain ruptures, causing bleeding in the brain 2.
Causes and Risk Factors
- Hypertension is the most important modifiable risk factor for CVA, although its contribution differs for different subtypes 2.
- Other risk factors for CVA include atrial fibrillation, diabetes, high cholesterol, and smoking 3, 4, 5, 6.
- CVA can also be caused by a wide range of other factors, including small vessel arteriolosclerosis, cardioembolism, and large artery athero-thromboembolism 2.
Treatment and Management
- Treatment for CVA depends on the type and severity of the stroke, as well as the individual's overall health 3, 4, 5, 6.
- Medications such as alteplase may be used to treat ischemic CVA, while anticoagulants may be used to prevent further strokes in patients with atrial fibrillation 3, 4, 5, 6.
- Management of CVA also involves addressing underlying risk factors and preventing further strokes through lifestyle changes and medical treatment 2.