Sunday, June 2, 2013

Difference between CVA and TIA

A cerebral vascular accident (CVA) is the most commonly seen stroke. These patients will experience a positive arm drift, unequal grip, facial droop, aphasia or dysphasia, and sometimes unequal pupil response. Now, a CVA is broken down into two types: hemorrhagic stroke and ischemic stroke. With the hemorrhagic stroke, their is a bleed within the brain. The bleed is caused by a rupture in the blood vessels in the brain. With the ischemic stroke, their is a blockage in one (or more) of the vessels in the brain, that cause a reduction in blood flow, which carries oxygen to the brain, thus causing a reducing in oxygen to the brain. This, if not treated soon, will result in total tissue death. For these patients, we want to start an IV of NS, get a 12-lead ECG, oxygen, monitor vitals closely, and priority 1 the patient to the ED.

A transient ischemic attack (TIA) is another type of "attack" to the brain. With these patients, you will note a positive arm drift, unequal grip, facial droop, aphasia or dysphasia, and sometimes unequal pupil response. But, these signs/symptoms will reside within a few minutes. Basically, a TIA is a short loss of neurological function, due to ischemia (reduced oxygen) in the brain. These patients may have a history of TIAs, which are also known as "mini strokes." Nonetheless, TIAs are a medical emergency. Just because the patient may have his/her s/s reside, does not mean that their is still not an issue. These patients need an IV of NS, 12-lead ECG, oxygen, and rapid transport to the ED.


Signs and symptoms of a stroke: Arm drift, unequal grips, slurred speech, facial droop, ahpasia or dysphasia, unequal pupil response, high systolic BP reading, H/A, AMS or confusion, and dizziness. In  some cases, the patient may be unresponsive.

Never give your stroke patient ASA. The reason for this, is because ASA is an anticoagulant, which helps in the reduction of blood clotting...which in turns, will cause the bleeding in the brain to continue.

With the oxygen, we will cause some, note "some," vasoconstriction, which will constriction blood vessels, thus reducing blood flow, thus reducing the amount of blood that is being released in the brain.

Patients who are a risk for any type of stroke include, but not limited to: Afib, HTN, cardiac issues, diabetic, hx of CVA/TIA, and others.

(Click on the picture above to enlarge)

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