CVA is a neurological event as described below:
Pathophysiology of CVA
1) necrosis of brain cells caused by a vascular event – usually classified as ischemic (embolus, thrombus, low flow state secondary to shock or cardiac event) or hemorrhagic (aneurysm, hypertension)
2) most common site of hypertensive CVA is basal ganglia-thalamus area (65%)
3) clinical presentation is a function of anatomic position of injury
Signs and Symptoms
1) ischemic CVA tends to have a somewhat gradual or “stutter” onset with preceding transient ischemic attacks
2) hemorrhagic usually acute onset with possible transtentorial herniation as hematoma expands
3) CVA in the cerebellar area – ataxia, headache, and vomiting
4) CVA in the pontine area – acute loss of consciousness and usually fatal
5) middle cerebellar artery area – headache, partial or complete hemiparesis, partial or complete hemiplegia and aphasia if dominant lobe is affected
Characteristic Test Findings
Radiology – best initial screening for CVA test is head CT (ischemic may not become evident for up to 48 hours)
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