CuraRN

Cerebrovascular Accident (CVA)

Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.

EMS etiologies

Setting: ER

A stroke, also known as a cerebrovascular accident (CVA) or brain attack, occurs when blood flow to the brain is interrupted, leading to cell death. There are two primary types of stroke:

• Ischemic stroke: Caused by a blockage in a blood vessel supplying the brain, leading to reduced blood flow and oxygen.
• Hemorrhagic stroke: Caused by bleeding in or around the brain, often due to a ruptured blood vessel or aneurysm.

Both types result in impaired brain function, which can lead to severe neurological deficits or death.

Clinical Presentation:

Common signs and symptoms of stroke include:

• Sudden weakness or paralysis on one side of the body.
• Difficulty speaking or understanding speech.
• Dizziness or loss of coordination.
• Vision loss in one or both eyes.
• Severe headache, particularly in hemorrhagic stroke.

If symptoms last less than one or two hours, it may be a transient ischemic attack (TIA), also known as a mini-stroke, which is a warning sign for future strokes. Strokes can lead to permanent neurological deficits and complications.

Treatment Modalities:

• Diagnosis involves a physical exam, CT or MRI scans to identify the type and location of the stroke, and tests such as electrocardiograms (ECG) and blood tests to assess underlying causes or rule out conditions like low blood sugar.

• Treatment depends on the type of stroke:

  • Ischemic stroke: If detected within 3-4.5 hours, clot-busting medications (thrombolytics) can restore blood flow.
  • Hemorrhagic stroke: Surgery may be required to alleviate pressure from bleeding.