A stroke, or Cerebrovascular Accident (CVA), occurs when an issue affects the blood supply to the brain. This serious medical event can cause irreversible damage if care is not immediate. Acting quickly helps limit health consequences and improves recovery chances. Understanding stroke is crucial for identifying its signs and reacting effectively.

What is a Stroke (Cerebrovascular Accident)?

Stroke happens when a part of the brain no longer receives enough blood, or when a blood vessel ruptures. Blood carries oxygen and essential nutrients to brain cells. Without this supply, cells begin to die within minutes. Doctors primarily distinguish two types of strokes, each with different causes and mechanisms.

Ischemic Stroke

Ischemic stroke is the most common type, accounting for about 85% of cases. It occurs when a blood clot blocks an artery leading to the brain. This clot can form in the artery itself (thrombosis) or travel from another part of the body (embolism), often the heart.

Hemorrhagic Stroke

Hemorrhagic stroke, less common, occurs when a blood vessel in the brain ruptures. This rupture causes a hemorrhage that damages surrounding brain cells through compression and blood irritation. Uncontrolled high blood pressure is the main cause of this type of stroke.

Causes and Risk Factors for Stroke

Several factors increase the risk of suffering a stroke. Some are modifiable, others are not. Understanding these elements helps in taking effective preventive measures and reducing the likelihood of a stroke occurring.

Modifiable Risk Factors

• High blood pressure: It damages blood vessels, making them more prone to blockages or ruptures.
• Smoking: Tobacco thickens the blood and promotes clot formation.
• Diabetes: Diabetes damages blood vessels in the long term.
• High cholesterol: Fat deposits can narrow arteries.
• Obesity and lack of physical activity: These lifestyle habits increase the risk of other factors like high blood pressure and diabetes.
• Atrial fibrillation: This heart rhythm disorder promotes clot formation.
• Excessive alcohol consumption: Alcohol can increase blood pressure.

Non-Modifiable Risk Factors

• Age: The risk of stroke increases with age.
• Family history: A family history of stroke may indicate a predisposition.
• Sex: Men have a slightly higher risk than women up to a certain age, then the risk balances or reverses.
• Ethnicity: Certain populations have an increased risk for specific causes of stroke.
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Symptoms and Signs of Stroke: Acting According to FAST

Quickly recognizing the signs of a stroke saves lives and limits disability. The acronym FAST (Face, Arm, Speech, Time) is a simple way to remember the main symptoms and the need to act quickly.

• F = Face: Is one side of the face drooping? Ask the person to smile.
• A = Arm: Is one arm weak or numb? Ask the person to raise both arms. Does one of them drift downward?
• S = Speech: Is the person having difficulty speaking or is their speech slurred? Ask them to repeat a simple sentence.
• T = Time: If you observe any of these signs, call 911 immediately. Every minute counts in treating a stroke.

Other symptoms may include sudden weakness or numbness on one side of the body, sudden vision problems, a sudden severe headache with no known cause, or a sudden loss of balance or coordination.

Stroke Diagnosis: How is a Cerebrovascular Accident Detected?

Rapid diagnosis is essential for choosing the appropriate treatment. Medical teams perform several tests to confirm a stroke, determine its type, and locate the affected area in the brain. This crucial step guides all stroke management decisions.

Imaging Tests

• CT scan (Computed Tomography): This is the first test performed. It helps distinguish an ischemic stroke from a hemorrhagic stroke, crucial information for treatment.
• Brain MRI (Magnetic Resonance Imaging): MRI provides more detailed images of the brain and helps identify areas affected by the stroke, even small ones, as well as early signs.
• Angiography: These tests (CT or MRI with contrast injection) visualize the blood vessels of the brain and detect blockages or aneurysms.

Other Tests

• Blood tests: They check blood clotting, sugar levels, and other important markers.
• Electrocardiogram (ECG): ECG looks for heart arrhythmias like atrial fibrillation, a common cause of stroke.
• Carotid ultrasound: This test evaluates the condition of the carotid arteries in the neck, which supply blood to the brain, and detects any narrowing.

Stroke Treatment and Management

Immediate stroke treatment aims to restore blood flow to the brain or control bleeding, thereby reducing damage. The speed of intervention directly impacts prognosis and recovery. Management then extends to rehabilitation.

Treatment for Ischemic Stroke (Clot)

• Intravenous thrombolysis: Doctors administer medication that dissolves the blood clot. This treatment is effective only within the first few hours after stroke symptom onset.
• Mechanical thrombectomy: A surgical procedure removes the clot using a catheter inserted into an artery. The specialist can perform this procedure several hours after the stroke for larger clots.

Treatment for Hemorrhagic Stroke (Bleeding)

• Medications: Some medications control blood pressure and reduce brain swelling.
• Surgery: The neurosurgeon may intervene to repair the ruptured blood vessel, remove accumulated blood, or decompress the brain.

Rehabilitation After Stroke

After the acute phase, rehabilitation is fundamental. It helps patients regain as many lost functions as possible. The rehabilitation team may include physical therapists, occupational therapists, and speech-language pathologists. It helps compensate for the effects of stroke.

Recent Scientific Advances in Stroke (June 2025)

Stroke research remains very active, with constant efforts to improve prevention, treatment, and rehabilitation. Although no major universally adopted advances impacting clinical practice were published in the first half of 2025, several promising avenues are progressing.

Scientists are intensely exploring neuroprotection for the hours following a stroke, seeking molecules capable of protecting neurons during ischemia. Clinical trials are studying agents that could reduce immediate brain damage before and after vessel recanalization. These researches have not yet led to widespread clinical treatments, but they represent hope for the future.

Furthermore, telemedicine and the use of artificial intelligence to optimize pre-hospital care and referral of patients to specialized centers continue to develop. These tools aim to shorten intervention times, which are essential for the effectiveness of reperfusion treatments.

Stroke Prevention: Is It Possible to Reduce the Risk?

Yes, preventing a stroke is largely possible by managing modifiable risk factors. Adopting a healthy lifestyle is the best defense against this serious disease. Simple changes can have a significant impact on vascular health.

Key Prevention Measures

• Control your blood pressure: Measure it regularly and follow your doctor’s advice.
• Manage diabetes: Maintain stable blood sugar levels, a crucial element to avoid vascular complications.
• Monitor your cholesterol: Adopt a balanced diet and, if necessary, take prescribed medications.
• Quit smoking: Smoking cessation drastically reduces the risk of stroke.
• Adopt a healthy diet: Prioritize fruits, vegetables, whole grains, and reduce saturated fats and salt.
• Exercise regularly: Physical activity helps maintain a healthy weight and control risk factors.
• Limit your alcohol consumption: Moderate consumption is recommended to prevent a stroke.
• Manage stress: Chronic stress can influence blood pressure.
• Consult your doctor: Have regular health check-ups to detect and manage risk factors early.

Living with Stroke

Living with a stroke often involves significant adjustments due to potential sequelae. However, many people regain significant independence through rehabilitation and appropriate psychological support. The goal is to regain the best possible quality of life. Perseverance is a notable quality among stroke survivors.

Sequelae and Adaptation

• Motor sequelae: Weakness or paralysis on one side. Physical therapy helps regain mobility and learn new ways of doing things.
• Speech and language disorders (aphasia): Speech therapy works to improve verbal and non-verbal communication.
• Cognitive problems: Difficulty with memory, attention, or problem-solving. Occupational therapy offers strategies to manage these daily challenges.
• Emotional disorders: Depression, anxiety, or mood swings are common. Psychological support is beneficial.

The Role of Family and Friends

Family and friends play an essential role in the recovery and adaptation process after a stroke. Their support encourages the patient and facilitates their return to an active life. Support groups also offer a space to share experiences and advice.

Frequently Asked Questions (FAQ) about Stroke

What are the first signs of a stroke?

The first signs of a stroke include sudden drooping of one side of the face, weakness or numbness of an arm, and difficulty speaking or slurred speech. This is the principle of the FAST test (Face, Arm, Speech, Time).

Can one fully recover from a stroke?

Full recovery depends on the type of stroke, its severity, and the speed of treatment. Many people recover well, especially with intensive rehabilitation, but some may retain sequelae. Recovery is possible and is a primary goal.

What are the most common sequelae after a stroke?

The most common sequelae of stroke are weakness or paralysis on one side of the body, speech disorders (aphasia), memory or concentration difficulties, and emotional changes such as depression.

How can a second stroke be prevented?

To prevent a second stroke, control your blood pressure, diabetes, and cholesterol. Quit smoking, adopt a healthy diet, exercise regularly, and take your prescribed medications. Regular medical follow-up also aids prevention.

What is the ideal time frame to treat a stroke?

The ideal time frame for treating an ischemic stroke is less than 4.5 hours for thrombolysis, and up to 6 hours (or even longer in some specific cases) for mechanical thrombectomy. The earlier the treatment, the better the chances of recovery. The brain loses millions of neurons every minute without oxygen.

Additional Resources

• WHO

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