From the Guidelines
Acute Cerebrovascular Accident (ACV) is defined as a documented history of stroke or cerebrovascular accident with acute loss of neurological function caused by an ischemic or hemorrhagic event with residual symptoms at least 24 hours after onset. This definition is based on the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards 1. The most likely etiologies of ACV include:
- Larger-artery disease (e.g., carotid)
- Small-artery disease (lacunar)
- Embolism
- Other, specify
- Not specified The diagnosis of ACV is typically confirmed by CT, MRI scan, or cerebral angiography 1. The assessment of ACV outcomes is categorized into:
- Complete/near-complete recovery (able to return to prestroke level of function)
- Mild to moderate deficit (deficits present, but patient can perform activities of daily living, such as dressing and feeding, with no or little assistance)
- Severe deficit (required assistance to complete activities of daily living) It is essential to note that the definition and assessment of ACV are crucial for determining the appropriate treatment and management plan, which can significantly impact patient outcomes and quality of life 1.
From the Research
Definition of Acute Cerebrovascular Accident (ACV)
- Acute Cerebrovascular Accident (ACV) is also known as stroke, which refers to an acute onset of neurologic deficits lasting more than 24 hours or culminating in death caused by a sudden impairment of cerebral circulation 2.
- The World Health Organization (WHO) defines stroke as "rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours with no apparent cause other than of vascular origin" 3.
- ACV can be subdivided into two major classifications: ischemic and hemorrhagic 3.
- Ischemic strokes occur from thrombi, emboli, or global hypoperfusion, while hemorrhagic strokes are either parenchymal or subarachnoid 3.
Acute Cerebrovascular Syndrome (ACVS)
- The concept of ACVS includes Transient Ischemic Attack (TIA) in acute settings and Acute Ischemic Stroke (AIS) 4.
- ACVS is comparable to acute coronary syndrome (ACS), which includes unstable angina and acute myocardial infarction 4.
- The mechanism of ACVS is complicated and includes large artery atherosclerosis, cardioembolism, or small vessel occlusion 4.
Risk Factors for ACV
- Hypertension, atrial fibrillation, and diabetes mellitus are the most common risk factors for acute cerebrovascular events 5.
- The cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke 5.
- Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, while hypertension and diabetes are more common in patients with lacunar stroke 5.