Risk Factors for Cerebrovascular Accidents (CVAs)

CVAs, also known as strokes, are caused by a sudden interruption of blood flow to the brain. This can happen when a blood vessel in the brain bursts or becomes blocked by a blood clot. CVAs can cause a wide range of symptoms, including paralysis, numbness, and vision problems. In some cases, CVAs can be fatal.

There are a number of risk factors for CVAs, including:

• Age: The risk of stroke increases with age.
• High blood pressure: High blood pressure is the leading risk factor for stroke. It damages the blood vessels in the brain and makes them more likely to burst.
• High cholesterol: High cholesterol can lead to the formation of plaques, which can narrow or block the blood vessels in the brain.
• Diabetes: Diabetes damages the blood vessels throughout the body, including the brain.
• Smoking: Smoking damages the blood vessels and increases the risk of blood clots.
• Obesity: Obesity increases the risk of high blood pressure, high cholesterol, and diabetes, all of which are risk factors for stroke.
• Family history: A family history of stroke increases your risk.
• African American race: African Americans are at higher risk of stroke than other racial groups.
• Other medical conditions: Other medical conditions that can increase the risk of stroke include heart disease, atrial fibrillation, carotid artery disease, and sickle cell anemia.

Cultures at Higher Risk for CVAs

Certain cultures are at higher risk for CVAs than others. For example, African Americans are at higher risk than white Americans. This is likely due to a number of factors, including higher rates of high blood pressure, high cholesterol, diabetes, and obesity among African Americans.

Additionally, certain cultures have traditional diets that are high in salt, fat, and cholesterol. These diets can increase the risk of CVAs.

0 to 4+ Scale for Scoring Deep Tendon Reflexes

Deep tendon reflexes (DTRs) are involuntary muscle contractions that occur when a tendon is tapped with a reflex hammer. DTRs are a test of the function of the nerves and muscles that control the reflex.

DTRs are scored on a scale of 0 to 4+, with 0 being no reflex and 4+ being a hyperactive reflex.

Here is a brief description of each score:

• 0: No reflex
• 1: Hypoactive reflex
• 2: Normal reflex
• 3: Hyperactive reflex
• 4+: Clonus (sustained muscle contractions)

DTRs are often tested in the legs and arms. The most common DTRs tested are the biceps reflex, triceps reflex, patellar reflex, and ankle reflex.

What to Expect in a Patient with Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy is a type of nerve damage that can occur in people with diabetes. It is caused by high blood sugar levels damaging the nerves in the body, especially the nerves in the feet and legs.

Symptoms of diabetic peripheral neuropathy can include:

• Numbness or tingling in the feet and legs
• Burning pain in the feet and legs
• Muscle weakness in the feet and legs
• Difficulty with coordination and balance
• Loss of reflexes in the feet and legs
• Foot ulcers and infections

In severe cases, diabetic peripheral neuropathy can lead to amputation.

Experience Encountered

I have encountered a number of patients with diabetic peripheral neuropathy during my career as a healthcare professional. One patient that I remember particularly well was a man named John. John was a 65-year-old man with type 2 diabetes. He had had diabetes for over 20 years and had developed diabetic peripheral neuropathy in his feet and legs.

John came to see me because he was experiencing pain and numbness in his feet. He also had difficulty walking and balancing. I examined John’s feet and found that he had several foot ulcers. I also tested his DTRs and found that they were hypoactive.

I diagnosed John with diabetic peripheral neuropathy and started him on medication to help control his blood sugar levels. I also taught him how to care for his feet and prevent ulcers.

John’s symptoms improved over time. His foot ulcers healed and he was able to walk and balance better. However, he still has some residual nerve damage in his feet and legs.

I am grateful that I was able to help John manage his diabetic peripheral neuropathy. I know that this condition can be very debilitating and can lead to serious complications. However, with proper care and management, most people with diabetic peripheral neuropathy can live long and healthy lives