Stroke or otherwise known as cerebrovascular accident (CVA), or sometimes called as cerebrovascular disease (CVD) is the infarction of a specific portion of the brain brought about by insufficient blood supply. Stroke may occur due to thrombosis; embolism due to fragments of blood clots, presence of a tumor, fat, bacteria or air; intracerebral hemorrhage because of a ruptured cerebral vessel which causes bleeding in the brain; cerebral arterial spasm, or irritation of the outer portion of the arterial wall which later on reduces the flow of blood to the brain; and compression of cerebral vessels because of tumor, blood clot, or swollen brain tissue. It may be divided into two: hemorrhagic and occlusive or ischemic.

Occlusive stroke results from thrombosis and formation of emboli. The effects of occlusion vary with its extent of involvement, time, and location. While hemorrhagic stroke is the effect of intracranial bleeding, this is the most common cause of death in CVA. Bleeding may occur deep within the surface of the brain.

The risk factors for stroke are the following:

  • Cardiac illness
  • Hypertension
  • Previous ischemic attack/s
  • Atherosclerotic disease of the intra and extra cranial vessels
  • Hypercholesteremia
  • Diabetes Mellitus
  • Polycythemia
  • Smoking
  • Emotional stress
  • Obesity
  • Sedentary lifestyle
  • Family history of stroke
  • Age (Incidence increase with age)

Stroke Pathophysiology & Schematic Diagram

Signs and Symptoms that may precede stroke are:

  • Paresthesia
  • Hemiplegia
  • Transient loss of speech
  • Severe nuchal or occipital headaches
  • Vertigo or syncope
  • Motor or sensory disturbances
  • Epistaxis
  • Retinal hemorrhage
  • Vomiting
  • Seizure
  • Fever

On the other hand, these are the signs and symptoms occurring after stroke:

  • Hemiplegia
  • Aphasia
  • Apraxia
  • Hemianopia
  • Agnosia
  • Dysarthia
  • Kinesthesia
  • Bowel or bladder incontinence
  • Shoulder pain
  • Unilateral neglect
  • Memory and spatial perception or loss of direction
  • Mood swings
  • Social withdrawal
  • Inappropriate sexual behavior
  • Sudden outbursts of anger
  • Regression


  1. Lippincott Williams & Wilkins (2012). Critical Care Nursing Made Incredibly Easy! 3rd Edition.
  2. Palandri, M.K. and Sorrentino, C.R. (1993). Black and Matassarin – Jacobs, Pocket Companion for Luckmann and Sorensen’s Medical –  Surgical Nursing: A Psychophysiologic Approach. 4th Edition. W.B. Saunders.


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