Transient Ischemic Attack – Medical Disorders

Medical Disorders

Cerebrovascular accident (CVA)

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What type of cerebrovascular accident (CVA) did you have?

A CVA is a sudden neurologic deficit resulting from an ischemic or hemorrhagic event that interrupts cerebral blood flow, causing reversible or irreversible damage to brain tissue. A CVA may cause an infarction (complete stroke) or a reversible event (TIA), such as:

• Stroke, an irreversible neurologic event, causes permanent disability. The typical signs and symptoms of a stroke are characterized by:

Face – Does one side of the face droop? Ask the patient to smile.

Arms – Is one arm weak or numb? Ask the patient to raise both arms. Does one arm drift downward.

Speech – Is speech slurred? Ask the patient to repeat a sentence.

Time – If the patient shows any of these symptoms, alert EMS immediately.

• Transient ischemic attack, a reversible focal neurologic event lasting from a few minutes to 24 hours. This type of event is a warning sign; the patient can expect more TIAs or even a full stroke. The typical signs and symptoms of a TIA are characterized by:

WALK (Is your balance off?)

TALK (Is your speech slurred or face droopy?)

REACH (Is your vision all or partly lost?)

FEEL (Is your headache severe?)

• Reversible ischemic neurologic deficit (RIND), a reversible focal neurologic event lasting longer than 24 hours. This type of event is a warning sign; the patient can expect more RINDs or even a full stroke.

What are your risk factors for CVA?

Risk factors for stroke are similar to those of ischemic heart disease: hypertension, smoking, physical inactivity, diabetes, hyperlipidemia, and atrial fibrillation.

Apart from these traditional risk factors, certain diseases and conditions put the patient at risk for the development of stroke. These comorbid maladies are other cardiovascular conditions, heart failure, left ventricular dysfunction, mitral and aortic stenosis, prosthetic heart valve, and atrial fibrillation.

Do you have any long-term effects from the CVA?

Residual neurologic deficits of varying degree and duration are common after a CVA. These include, among others, minimal to severe motor dysfunction, sensory impairment, visual defects, speech difficulties, dysphagia, dizziness, seizures, dyspnea, sleep problems, and memory deficits. In addition, depression is a common condition affecting many patients after a stroke.

What types of medications are you taking?

Medications are given based on underlying conditions, as well as to prevent the patient from developing a stroke. Most patients at risk for, or those who have experienced, an ischemic stroke will be on anticoagulation therapy.

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Related Pages

• Medical disorders
  • Atrial Fibrillation
  • Cardiovascular Disease
  • Diabetes
  • Heart Failure
  • Hypertension
  • Stroke
• Oral Health Care Considerations
  • Antiplatelet and Anticoagulation Therapy Considerations
  • Stroke
• Laboratory Values
  • Cholesterol
• Medical Emergencies
  • Stroke

References/Websites

• References
  • Chen TT, et al. Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments. JDR. 2019;98(2):157-163.
  • Hankey GJ. Antithrombotic therapy for stroke prevention. Circulation. 2019;139:1131–1133.
  • Hankey GJ. Stroke. Lancet. 2017;389(10069):641-654
  • Lacey B, et al. Systolic blood pressure and vascular disease in men aged 65 years and over. The HIMS (Health in Men Study. Hypertension. 2017;69:1053-1059.
  • Ovbiagele B, et al. Level of systolic blood pressure within the normal range and risk of recurrent stroke. JAMA 2011;306(19):2137-2144.
• Websites
  • National Aphasia Association.
  • NIH Stroke Scale.
  • Transient Ischemic Attack Information Page. National Heart, Lung, and Blood Institute.
  • Transient Ischemic Attack. MedlinePlus. U.S. National Library of Medicine. April 12, 2021.
  • Stroke. National Heart, Lung, and Blood Institute.
  • Stroke. MedlinePlus. U.S. National Library of Medicine. May 20, 2021.
  • What is a stroke? UCLA Health.