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TIA at 33 yrs old
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Wendy1229 posted:
Hi. I dont smoke, no history of migraines, not on Birth Control bills, I have low blood pressure and I am not overweight.

About 2 weeks ago It was discovered I had a TIA, actually my scan showed i have had at least 3. It started with nausea and dizziness then several minutes later I couldn't speak. I was home by myself with my 9 yr old son and 4 yr old daugher, my son knew something was wrong and he called my husband on my cell while I called 911 it took a few minutes to convey what my problem was but then I suddenly had my speech back. I went to the ER anyway where they did a CT SCAN and BW immediately. But it was another 3 hours before anybody talked me, nurses came in and checked on me but that was it. Then i had a very intense dizzy spell the room was spinning and became very nauseous and a vomitted quite a bit. Finally a dr came in said my CT was fine he gave me meclizine, toradal, and zofran. And said this may be vertigo, a few more hours went by and he said "yep seems like vertigo I think you can go home" my husband asked why couldn't she speak? We talked a bit more then dr said "no your being admitted and we are doing an MRI, echo, and caratid ultrasound.

A neurologist finally came in and did a consult he added a bubble study. Ultrasound of Caraids was normal, echo was inclusive because of my chest bones, and my MRI came back positive for Multiple TIA on both sides of the cerebellar hemispheres my right side showed a spot of 1cm.

Cardiologist decided to do a TEE since my echo was incomplete. I also had a ton of BW for hypercoagulability. TEE showed i have a PFO in my heart very small, they do not feel it needs to be closed at this time. My BW came back positive for Protein C deficiency. But the hematologist is ordering more BW because he doesn't feel like I have a true protein C def. (I have had several miscarriages in the past) He is looking for a Prothrombin gene mutation(factor II).

all of Neuro exams have been good I dont have any lose of function. I am on coumadin and aspirin. But feel so stuck because cardio thinks its a blood clotting issue not the PFO and hematologist thinks its the PFO and not the blood clotting issue.

I am switching moods between anger and just being scared. Angry because I dont understand why it happened, upset because it happen and mad no one can give me any answers. Also mad that ER didn't give me any kindd of aspirn I was left in a room for 3 hours. Mad my kids got the scar of a lifetime

I am freaked this will happen again freaked if it does it will be worse. Why did this happen/
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Richard C Senelick, MD responded:
It is common to ask, "Why me?" The real answer to that is usually, "we don't know ." You didn't do anything wrong and sounds like you may have an abnormality that would no one would have suspected until there was a problem. It sounds like you are getting excellent care and have had an extensive workup that has come up with two possibilities for your TIAs. Unfortuntaely, we cannot always make a definite diagnosis.

A very recent study on the treatment of PFOs concluded that medical treatment is as good as closure. In light of that, you are on medical treatment for the PFO and for any clotting issues. It sounds like the hematologist has a bit more detective work to do. About 30% of the time we cannot tell the patient exactly why they had a TIA or stroke, but it would seem in your case that the treatment will be the same.

As for the aspirin, it would not have been appropriate for the ER to give you one. We do not do that for stroke. Likewise, you would not have been a candidate for tPA.

If you are still concerned after all the tests are back, you can gather up all the test results and get a second opinion at major stroke center.

Good Luck.
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
 
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Wendy1229 replied to Richard C Senelick, MD's response:
thanks for the response but I have More questions

Why would a CT SCAN come back fine and then a MRI 8 hours later be postive for Stroke if the MRI sees more why isn't that the standard of care instead of a CT Scan?

And is it normal to feel tired easily after having TIA?. I have days where I am just exhausted and honestly I am not doing that much.

I was also asked if I had any long travels before the TIA and I didn't however I do sit quite a bit at work and on weekends I can sleep 10 hours straight. Is that to much being still? I am freaked out over that now.

Thanks
 
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itmatsb replied to Wendy1229's response:
My neurologist told me that a CT scan should definately be the first thing to get when a stroke is suspected because the results are far quicker. If you do have a stroke that can be treated with tPa, the quicker you can find out the better. Three hours later, it can't work, but the sooner you get it, the more the tPa can counteract the stroke. But not every stroke can be treated wtih tPa. For example, I had a carotid artery dissection stroke. It would have killed me if they had given me tPa.

Since no one else has replied to you in a week, I'll venture what my memory remembers which may be incorrect, but then maybe someone who knows will answer. I believe that the MRI is the way to diagnose a TIA.

And yes, people are often very exhausted and disabled with deficits for awhile after TIAs. They are told that the TIAs effects don't last, but on another medical site, there are countless people complaining about effects lasting for months.

So give yourself some time and rest with what you have gone through and search for more information.

Good luck.


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Richard C. Senelick M.D. is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He did his undergraduate and medic...More

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