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Old 07-09-2010, 12:53 PM   #1
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Stroke-like symptoms after a TIA

A little history,
I had a heart attack in February of 2009 (95% blockage of right posterior circumflex), in January 2010 I suffered a TIA (sitting at my desk at work). In May of 2010 I began suffering stroke-like symptoms when ever my BP would rise, one event in May was enough to put me in the hospital thinking it was another TIA/stroke.

The symptoms are (in order of appearance): numbness in the left cheek, drooping of the the left side of mouth, difficult speaking (physically), nausea/difficulty thinking/dizziness (the last are grouped because I am unsure of their order -- I do not often allow it to get to that point, and once I am there it is difficult to remember what is happening).

My memory is not as good as it was prior to the TIA in January (unsure if that is important.

Since then I have had symptoms almost daily, some worse than others. I had a normal cerebral arteriogram in June and an abnormal cervical MRI in June as well.

The MRI results were that the C3/C4, C4/C%, & C5/C6 levels all had neuroforaminal narrowing and left facet joint arthopathy. The C5/C6 level has a "broad-based disc bulge indenting on the ventral thecal sac and slightly flattening the spinal cord", "[COLOR="rgb(0, 100, 0)"][m]ild narrowing to the spinal canal is seen[/COLOR]", as well as "[COLOR="rgb(0, 100, 0)"]an uncovertebral osteophyte[/COLOR]".

The question I have is whether these can explain my stroke-like symptoms?


I am seeing a neurosurgeon and neurologist to find answers, but my patience has never been good.

Thanks in advance.

Last edited by moderator2; 07-09-2010 at 01:49 PM.

 
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Old 07-15-2010, 11:42 PM   #2
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Re: Stroke-like symptoms after a TIA

Strokey (great name),

Welcome to the stroke board. We have a great group here, all tying to learn while we support each other through stroke recovery.

I am not sure of the relationship between your abnormal spinal findings, and your stroke symptoms, but I will sure try to help you figure this out.

I survived 4 strokes 7 years ago, and have been writing in support of other stroke survivors for the last, well lets say 2,800 times ago... a few good years.

I am interested in the event in May...your symptoms meet all the guidelines for stroke, and you went to the hospital...what was the outcome of that hospitalization? Did they come out and say you have had another stroke?

Were you left with different or worse losses after the second stroke? Did you return to work? What prompted them to do spinal imaging? I do not understand the correlation between the two?

Are the "almost daily" symptoms worse following the event in May? Or the same as before?

Lets try to talk this one out...

 
Old 07-18-2010, 04:04 PM   #3
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Re: Stroke-like symptoms after a TIA

Quote:
I am not sure of the relationship between your abnormal spinal findings, and your stroke symptoms, but I will sure try to help you figure this out.
Thank you in advance, and I apologize for the delay in responding -- I was actually on vacation.

Quote:
I am interested in the event in May...your symptoms meet all the guidelines for stroke, and you went to the hospital...what was the outcome of that hospitalization? Did they come out and say you have had another stroke?
The January event was confirmed as a likely TIA. Although the possibility exists that the January event did result in rerouting of neural pathways -- I have permanent drooping in my left upper lip at rest, but I retain complete control over the lip (albeit a a different level of "finesse", my wording).

In May the diagnoses by the on call neurologist (once a TIA/stroke was ruled out) was that this event was due to platelet aggregation, and unlikely to be dangerous. Hindsight allowed me to realize that the symptoms had occurred twice in the two weeks prior to the May event.

A major part of the reason (per the neurologist I saw in the hospital and later affirmed by both my neurologist and neuro-surgeon) for not calling the May (and subsequent) events a TIA/stroke is the fact that the symptoms come on relatively gradually and (usually) in sequence rather than suddenly and all at once.

Quote:
What prompted them to do spinal imaging?
After the May event, one of my doctors contacted a friend of his to get me an appointment -- his friend happened to be the Chief of Neurosurgery at a regional center (the "go to" place for stroke victims, with a floor dedicated to stroke patients. After looking over my history, the various reports and discussing the continued symptoms, the neurosurgeon recommended a cerebral angiogram to rule out an aneurysm or other physical problem within the brain. When that came back clean he ordered a cervical MRI to rule out any problems that would have been missed by the carotid ultra sound done in January.

Quote:
Are the "almost daily" symptoms worse following the event in May? Or the same as before?
Following the May event I was able to recognize the onset of symptoms, I began logging them on 8 June 2010. The severity of symptoms in general have been mild (limited to numbness in my cheek and increased drooping of my lip, possibly with trouble physically speaking, but no outright slurring or trouble mentally forming the words). I have found that any activity that will raise my blood pressure will bring on symptoms, the faster and more prolonged the excitement, the more severe the symptoms -- I think (but I am not certain, maybe 65%), that the speed of rise tends to bring on more severe symptoms, but if I persist the symptoms will progress. I have limited my music choice while driving to avoid getting to excited.

N.B. The symptoms are classic stroke symptoms (in order of appearance): numbness of the (left) cheek, drooping of the lip/mouth, slurring of speech, mental fuzziness/dizziness, & nausea (the last two can flip-flop).

Quote:
Did you return to work? I do not understand the correlation between the two?
I am in IT, but I do not pull cable as part of my job, so returning to work was actually a given (at least until my mind goes). Seriously, after the January event I began questioning every lapse, typo, error, etc. in terms of diminished capacity. As a cheat I began doing what I did when I was in school (actually quite recently, my degree dates from 2008), and writing everything down -- I use the Levenger Circa system and material from DIYplanner.com.

As to the correlation, that is what I seek. I think the cervical issues provide answers to some of the other problems that I have. I do wonder if the flattening of the spinal cord can explain the symptoms I have

 
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