Medical Education Article – To Know and Prevent Cerebral Vascular Accident

I. What is cerebral vascular accident (VCA or stroke) Stroke is temporary or permanent cerebral dysfunction caused by reduction or stop of cerebral blood flow. It will lead to paralysis, unconsciousness, loss or impairment of language ability, incontinence, etc. Stroke is so far the second most common cause of death in Taiwan. And the number of death from stroke rises with advancing age.

II. Different types of stroke and the causes A. Cerebral infarct.
  • Cerebral thrombosis: cerebral atherosclerosis makes blood vessels become narrower and finally lead to a blockage.
  • Cerebral embolism: a blood clot that forms elsewhere in the body before traveling through the blood vessels and lodging in the brain.
B. Cerebral hemorrhage: a blood vessel bursts inside the brain and bleeds which is often caused by hypertension and cerebral atherosclerosis.
C. Transient Ischemic Attack (TIA): it occurs when the blood supply to part of the brain is briefly interrupted, and leads to temporary cerebral dysfunction. The neurologic deficit would be recovered entirely within twenty-four hours. Usually the occurrence of TIA is considered an important warning of developing cerebral infarct.

III. Causes of Stroke A. Major risk factors: It is more likely to cause CVA as below.
  • Elderly people: Cerebral infarct is more easily found in the elderly due to their losing cerebral vascular elasticity.
  • Patients of Hypertension: Hypertension often due to atherosclerosis, which causes infarction and rupture of vessels.
  • Patients of heart disease: Especially valvular heart disease, heart failure, myocardial infarction, and arrhythmia.
  • Patients of diabetes: Diabetes accelerates the thickening process of blood vessel wall and atherosclerosis, which is likely to cause cerebral infarct.
  • People with history of TIA: Stroke may occur in TIA patients before long.
  • People with history of stroke: If the disease is not seriously controlled and prevented, the recurrence rate of CVA is extremely high.

B. Minor risk factors: When the major and minor factors happen together, it is more possible to develop stroke.
  • Hyperlipidemia, obesity
  • Polycythemia
  • Taking oral contraceptive
  • With family medical history of CVA
  • Smoking or alcohol abuse
  • Low physical activity

IV. Prevention of stroke. A. Regular health examination: People in the age of forty or above are suggested to a undergo health check annually.
B. Blood pressure monitoring: People whose systolic pressure is higher than 130 mmHg and diastolic pressure is higher than 85 mmHg should measure and record the blood pressure once a week. If the blood pressure suddenly increases to 160 mmHg systolic and 90 mmHg diastolic, they should take a rest for half an hour and measure again.
If it stays high, or accompanying headache, dizziness, neck stiffness, it is recommended consulting a doctor immediately. C. Balanced diet: Following the healthy diet principles with less salt, less sugar, less oil, and drinking enough water.
D. Regular exercise: the suggested principles is as following.
  • Avoid exercising under too high or too low environmental temperature.
  • Warm up thoroughly before exercise.
  • Do not go beyond the athletic ability.
  • Slow the pace gradually when finish exercising instead of stopping the movement suddenly.
  • After exercising, a shower should not be taken until body has stopped sweating. And it is better to use lukewarm water for showering and avoid taking sauna.
E. Patients of hypertension, diabetes, and heart diseases should comply with instructions provided by a doctor, and follow up regularly.
F. Stabilize mood.
G. Quit smoking, alcoholic abusing and habits bad for health.
H. Keep body warm when temperature drops.
I. Avoid exerting strength too suddenly.
J. Avoid constipation.