The CVA, popularly called a stroke, is the acronym for cerebrovascular accident, the medical term used when a part of the brain suffers an infarction, usually due to a failure in blood circulation.
A stroke can also be called an EVA (Encephalic vascular accident), which will be a more accurate description, since the brain encompasses not only the brain but also the cerebellum, hypothalamus and brainstem, areas of the central nervous system likely to suffer an infarction.
In this text we will cover 7 classic signs and symptoms of a stroke that should serve to alert the patient to seek medical attention immediately. The emergency treatment of stroke cases is essential because the treatment is only effective if started within first hours of a stroke.
If you want more explanation about other possible symptoms of a stroke, risk factors, differences between ischemic strokes, hemorrhagic strokes and transient ischemic attacks, and treatment options.
A typical sign of a stroke is the sudden asymmetrical weakness of limbs. Generally, the lack of power affects an arm, a leg or an arm and a leg on one side of the body. The loss of driving force can range from very mild weakness to total paralysis. A sudden and unilateral motor weakness is typical. It is common for a stroke that both legs or both arms to be affected at the same time with the same intensity. Numbness, tingling or a sensation of light pins and needles may also be present.
Paralysis, or a near paralysis, are easily identifiable by the patient and their families. The difficulty arises when the loss of strength is discrete. In this case a simple test can be done. Raise your arms and hold them for a few seconds with the shoulders aligned (position mummy or sleepwalking). If one arm begins to fall involuntarily there is a strong indication of motor weakness. The same test can be done with the legs, just sit back and lift your legs, leaving the knees straight.
The palsy usually appears quickly, however, can only start with tingling and mild weakness, progressing to frank loss of strength only after several hours.
The shift towards the mouth contrary to the paralyzed side is the most common and noticeable sign. Look at the figure. This patient has a facial paralysis on the left. Note that the mouth deviates to the right side and labial (aka Chinese mustache) disappears to the left, becoming more prominent on the right.
In case of a stroke paralysis tends to preserve the upper half of the face, and the patient is able to frown and raise eyebrows. This tip is important because in Bell's palsy, picture caused by inflammation of the facial nerve, and every patient is paralyzed hemifacial.
Other signs and symptoms that speak in favor of a stroke, and not of Bell's palsy is the loss of strength in other areas of the body, as members, changes in speech, vision loss, imbalances or any other typical symptom of a stroke. Bell's palsy affects solely a face.
In some cases the facial paralysis is milder and may go unnoticed by family members. A tip to see if the mouth is diverted is to ask the patient to smile or whistle. If there is paralysis, it will be easily noticed with these maneuvers.
Another typical sign of a stroke is change of speech. The patient with a stroke may present a range of disorders that in the end is characterized by a difficulty speaking. The two most common changes are aphasia and dysarthria.
Aphasia is the inability of the patient to name objects and things. The patient can not speak normally because they cannot say simple names such as colors, numbers and objects. In some instances the patient is not even able to repeat a word spoken by a family member. Depending on the aphasia, the patient may be able to think of the object, understand its meaning, but simply do not know how to say its name. It is a loss of verbal language. The speech can be confusing, because the patient can only say a few words, being unable to tell others.
Often the patient is also unable to write the name of these objects. There are types of aphasia in which the patient fails to understand what some words mean, can not speak, do not understand each other and can no longer understand what is written. In this case the patient loses the ability of language globally.
Dysarthria is another speech disorder and presents itself as a difficulty in articulating words. The patient understands everything, but he/she lacks motor skills to move the muscles of speech to articulate words correctly. The patient can even name things, but does it so wrapped, sometimes incomprehensible to the listener.
A change of discourse can also be caused by disorientation and confusion. The patient may lose track of time, not knowing the current year or month. They can also become spatially disoriented, not knowing where they are. These changes are common in small strokes in the elderly. Multiple small strokes can lead to dementia.
The patient with stroke may have difficulty walking. This gait may be caused by imbalances by decreasing strength in one leg or even by changes in motor coordination responsible for the act of walking. In the latter case the patient has preserved the strength of the lower limbs, but goes uncoordinated, having difficulty in taking steps.
There are cases in which the stroke can cause dizziness, causing the patient walking around being silly. However, in most cases patient does not feel dizzy, but still has no balance when walking. In fact the patient may not be able to stand still, falling sideways if not supported.
Some stroke cases manifest as seizures, which are generalized motor tremors associated with loss of consciousness. The seizure can be a symptom of a stroke, but may also be a sequel. Some patients become epileptic after having had a stroke. Learn more about epilepsy and seizure.
A sign of stroke severity is the reduced level of consciousness, sometimes to the point of falling into a coma. Loss of consciousness is usually a symptom of a stroke or an extensive hemorrhagic stroke. It is a sign of poor prognosis.