TIA vs. CVA and preventive measures for both

Jan. 28, 2019 / By Kelly Long, BS, CPC, CPCO, CAPM

Strokes, or more specifically cerebrovascular accidents (CVAs) run in my family, with both parents experiencing them before the age of 65. Seeing what my loved ones have experienced, as well as seeing my doctor’s eyebrows shoot up as I let her know my family history has led me to want to become more informed about CVAs and about any proactive measures I can take to decrease my risk.

Obstruction in blood flow (ischemia) to the brain can lead to permanent damage. This is called a cerebrovascular accident (CVA). It is also known as cerebral infarction or stroke. Rupture of an artery with bleeding into the brain (hemorrhage) is called a CVA, too. If the symptoms are temporary, usually lasting less than an hour without permanent brain damage, the event is called a transient ischemic attack (TIA).

CVAs and TIAs are rated based on the underlying cause and the most common cause is hypertensive and atherosclerotic plaque within the arteries to the brain (aka cerebrovascular disease or CVD). CVD can be complicated by clots (thrombosis) and by emboli from the heart. Because CVD is an indicator of atherosclerosis in other parts of the body, an individual with a history of TIA or CVA is at risk for coronary artery disease and recurrent stroke.

Strokes and TIAs are caused by the same problems. The risk factors that can lead to both strokes and TIAs most commonly include smoking, coronary artery disease, high blood pressure, diabetes, lipid disorders (such as high cholesterol), peripheral arterial disease and atrial fibrillation.

The signs and symptoms of a CVA and TIA include weakness, numbness, headaches, dizziness, nausea, vomiting, paralysis of one side of the body, speech difficulty and memory defects. Amaurosis fugax, a form of visual TIA, is temporary monocular (one eye) or partial blindness.

Tests are done to evaluate the brain circulation, such as a carotid ultrasound (Duplex) or angiogram (MRA). A brain scan (CT and/or MRI) is used to determine if an individual has had a stroke. A TIA will not show on a scan. TIA is never ruled-out by negative tests; diagnosis is adequately met by symptoms only.

Stroke Statistics

• Strokes kill about 140,000 Americans each year—that’s 1 out of every 20 deaths.
• Someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.
• Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes.
• About 185,00 strokes—nearly 1 of 4—are in people who have had a previous stroke.
• About 87 percent of all strokes are ischemic strokes, in which blood flow to the brain is blocked.
• Stroke costs the United States an estimated $34 billion each year. This total includes the cost of health care services, medicines to treat stroke, and missed days of work.
• Stroke is a leading cause of serious long-term disability. Stroke reduces mobility in more than half of stroke survivors age 65 and over.

Preventive measures

1. Lower blood pressure

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women.

2. Lose weight

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as ten pounds can have a real impact on your stroke risk.

3. Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

4. If you drink — do it in moderation

Drinking a little alcohol may decrease your risk of stroke. But once you start drinking more than two drinks per day, your risk goes up very sharply.

5. Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke.

6. Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

7. Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries.

I hope this valuable information about TIA and CVA will lead you on the path to improved stroke awareness and healthy living in 2019.

Kelly Long is a clinical development analyst with 3M Health Information Systems.

Transform your coding process.

References:

https://www.tba.com/wp-content/uploads/TransientIschemicAttack.pdf

https://www.cdc.gov/stroke/index.htm

https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke