Neurology Review: Identify the Difference Between CVA & TIA

Today, we’ll be focusing on a topic that is quite confusing for some – cerebrovascular accident (CVA) versus transient ischemic attack (TIA).

CVA and TIA are conditions that occur due to lack of oxygen in the brain. To compare, if there’s oxygen depletion or deprivation in the heart, the condition is called a heart attack. On the other hand, if there is decreased oxygen distribution to the extremities, the condition is called deep vein thrombosis (DVT) which is caused by a clot that blocked the veins ceasing or lessening the flow of blood.

Identifying CVA and TIA

Cerebrovascular accident is just a fancy word for stroke which is also sometimes called as a brain attack. On the other hand, the transient ischemic attack is the narrowing of the blood vessels inside the brain, causing a decrease in blood flow and oxygen supply. Therefore, ischemic just means decreased oxygen. Looking at an EKG strip, ischemia is easily identified when there is ST depression.

So remember, TIA is low O2 while CVA is no O2.

CVA and TIA Signs and Symptoms

When a client comes in and complains of weakness on any side of the body, it should alert the nurse for a stroke or CVA.

A CVA, as previously stated, is a clot inside the vessels of the brain that is stopping blood flow and oxygen from being distributed. The clot causes a backing up of blood, pushing the vessels and eventually, the vessels will burst – this is what happens in an aneurysm.

So, if there is a blood clot, the very first indication would be weakness on one side of the body, which is coined as hemiparesis. There would also be signs of aphasia which is a speaking impairment. Stroke will affect facial expressions and motor senses as well.

If a client has a stroke on one side of the body, this means that the opposite side of the brain is affected. Meaning, if the left side of the body has hemiparesis, the right side of the brain is affected.

FAST for Stroke

The Stroke Foundation came up with an acronym to check whether someone has a stroke or not and it’s called F.A.S.T. So, what does FAST stands for?

• Face – tell the client to smile and notice if there is weakening on one side of the face to check if there is unilateral neglect or hemiparesis.
• Affect of the face.
• Sent or grips – have the client raise his or her arms with both eyes closed, and if one arm goes down, you can consider the other side of the brain for a stroke.
• Talk – ask the client to say a word or phrase, and if they can’t pronounce the word or phrases, and if their speech is all jumbled up, it’s another indication of a stroke.

Nursing Intervention

If a client comes in and the nurse has assessed the condition as hemiparesis and aphasia, the client is to be wheeled directly to the CAT scan room to check the brain for any clots or narrowing. This procedure is essential in knowing whether the client has CVA or TIA. 

So, just remember, the major difference between CVA and TIA is that one is due to decreased oxygen and the other is no oxygen at all.

On our next lecture, we will be tackling the plan of care and implications of the two conditions. Check it out at SimpleNursing.com.