International Journal of Clinical Case Reports, 2025, Vol.15, No.3, 130-138 http://medscipublisher.com/index.php/ijccr 131 strategies to enhance the overall effectiveness of home-based emergency care for strokes. By addressing these objectives, the study seeks to contribute to the development of more effective educational programs and protocols that can be widely implemented to improve outcomes for stroke patients in home settings. 2 Cerebrovascular Accidents: An Overview Cerebrovascular accidents (CVAs), commonly known as strokes, are a significant global health concern due to their high incidence and potential for severe long-term disability. This section provides an overview of the pathophysiology and types of CVAs, the critical time-dependence in stroke management, and the consequences of delayed treatment in home settings. 2.1 Pathophysiology and types of cerebrovascular accidents Cerebrovascular accidents occur when the blood supply to a part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. This can lead to the death of brain cells within minutes. There are two main types of strokes: ischemic and hemorrhagic. Ischemic strokes, which account for about 87% of all strokes, are caused by blockages or narrowing of the arteries leading to the brain, resulting in severely reduced blood flow (ischemia). Hemorrhagic strokes occur when a blood vessel in the brain bursts, leading to bleeding in or around the brain (Minhas et al., 2019; Valan and Subramaniyan, 2022; Mason, 2024). Both types of strokes can cause significant neurological damage and require immediate medical intervention. 2.2 Critical time-dependence in stroke management The management of strokes is highly time-sensitive. The concept of "time is brain" underscores the importance of rapid treatment to minimize brain damage and improve outcomes. Early intervention, particularly within the first few hours of symptom onset, is crucial for the effectiveness of treatments such as thrombolysis in ischemic strokes (Asemota et al., 2016; Elbqry et al., 2019; Karri et al., 2023). Delays in treatment can lead to increased mortality and long-term disability. The use of telemedicine has been suggested as a potential solution to improve the speed and accessibility of stroke care, especially in resource-limited settings (Figure 1) (Kim, 2023). Figure 1 Emergency medical services and systems data and evidence flow (Adopted from Kim, 2023) 2.3 Consequences of delayed treatment in home settings Delayed treatment of strokes in home settings can have severe consequences. Without immediate medical attention, the extent of brain damage increases, leading to greater functional impairment and a higher likelihood of long-term disability (Valan and Subramaniyan, 2022; García et al., 2022) . In developing countries, the shortage of trained neurologists and inadequate healthcare infrastructure exacerbate these delays, resulting in higher morbidity and mortality rates (Asemota et al., 2016). Additionally, the lack of awareness and education among caregivers and patients about the signs and symptoms of strokes further contributes to treatment delays. Educational programs aimed at empowering caregivers with the knowledge and skills to manage stroke patients effectively have shown significant improvements in outcomes (Dehghan et al., 2022). In conclusion, understanding the pathophysiology and types of cerebrovascular accidents, the critical importance of timely intervention, and the dire consequences of delayed treatment in home settings is essential for improving stroke care and outcomes. Enhanced education and the use of telemedicine are promising strategies to address these challenges.
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