I Had Several TIAs Over The Past Three Months. I’m

Posted on Wed, 9 Jan 2019

Question: I had several TIAs over the past three months. I’m the last month they became more frequent. In the last three days I had three successive TIAs.

Yesterday I had complete right leg paralysis, a weak right arm that drifted, poor coordination, I could not write, my right face drooped and I had difficulty speaking. My blood pressure was 200/110.

A code stroke was called. A tele neuro doctor examined me and I was given TPA in the ER. My symptoms gradually returned to full function over 12 hours. The arm returned first, then toes, then ankle. Finally, I could move my leg. My walking now is slow, jerky and I feel dizzy and unbalanced.

My CTA showed tortuous basilar artery and narrowing of the distal basilar artery near the tip. I previously had 90% stenosis in that area and a thalamic lacunar stroke, with the same symptoms as now. They did a cerebral angioplasty to open it up. Could that area be the cause of this stroke? We’re all the TIAs leading up to this stroke?

Follow up: Dr. Dr. Erion Spaho (0 minute later)

I had several TIAs over the past three months. I’m the last month they became more frequent. In the last three days I had three successive TIAs.

Yesterday I had complete right leg paralysis, a weak right arm that drifted, poor coordination, I could not write, my right face drooped and I had difficulty speaking. My blood pressure was 200/110.

A code stroke was called. A tele neuro doctor examined me and I was given TPA in the ER. My symptoms gradually returned to full function over 12 hours. The arm returned first, then toes, then ankle. Finally, I could move my leg. My walking now is slow, jerky and I feel dizzy and unbalanced.

My CTA showed tortuous basilar artery and narrowing of the distal basilar artery near the tip. I previously had 90% stenosis in that area and a thalamic lacunar stroke, with the same symptoms as now. They did a cerebral angioplasty to open it up. Could that area be the cause of this stroke? We’re all the TIAs leading up to this stroke?

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
It is possible.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and here is my advice.

Since there were same symptoms and a thalamic stroke, the vertebrobasilar system insufficiency is very likely the cause.

These symptoms may arise from a stroke or a TIA of the vertebrobasilar system, in most cases, the weakness of the face is contralateral with the weakness of the limbs ( one side of the midbrain involved ), but there are variations.

However, a cardiac origin ( emboli, high blood pressure ) also should be considered and transesophageal ultrasound is a complementary examination in such cases.

Use of antiagregant drugs also is necessary to prevent other TIA's or stroke.

Discuss with your Neurolgist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Remy Koshy

Answered by Dr. Dr. Erion Spaho (0 minute later)

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Erion Spaho (35 minutes later)

What type of cardiac origin could be found with a TEE if there is one?

Follow up: Dr. Dr. Erion Spaho (0 minute later)

What type of cardiac origin could be found with a TEE if there is one?

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
Thromboembolic origin.

Detailed Answer:
Hello again.

TEE may show if there are any thrombi formed in the walls of the heart chambers.

So, this way a thromboembolic origin is assessed.

Hope I helped you.

Greetings.

Above answer was peer-reviewed by : Dr. Kampana