Question Title: Transient Ischemic Attack

Forum: Neurology Forum
Topic: Sleep

Posted by CCF NEUROSURGERY MD on October 09, 1997 at 10:24:15:

In Reply to: Transient Ischemic Attack posted by Sue on October 05, 1997 at 16:30:41:

: Recently my 85 yr old mother awoke around 5:30 a.m. to go to the bathroom. When she got to the bathroom, her knees gave way and she remembers falling. However, she did not realize that she had an injury to her arm apparently from hitting the sink.. The next thing she remembers is awakening in the emergency room and the nurses saying her sister was there to pick her up. This was around 9:00 a.m. She vaguely remembers two people with her, probably the paramedics. She does not remember calling 911 or walking to the front door and unlocking it and going back to the bedroom. Nor does she remember the ambulance ride or the hospital stay. The ER report said that she was speaking; however, her speech was slurred. She has since learned that the paramedics found her on the floor in her bedroom. The telephone was on the bed with the receiver off the hook. The hospital treated her for an injury to her arm. She saw her doctor on Monday, two days later. Could this have been a TIA? She takes one baby aspirin daily. She also takes 1/2 halcion for sleep each night. The doctor said that she may have taken too much halcion and this caused the memory loss. She doesn't think she took more than usual. The dr. didn't run any tests and said wait and see if it happens again. I'm afraid that may be too late.

She had a TIA about 2 1/2 yrs ago that lasted about 30 min. She fell, had slurred speech and was saying unusual things. However, she does remember most of it. She said that we seemed far away. I took her to the hospital where she stayed for a couple of days. She had a ct which showed nothing.The doctor said it was most probably a TIA.

Thanks for any info you can provide me.
______

A transient ischemic attack, or TIA, is characterize by a focal neurological
defect that lasts less than 24 hours. They may present as weakness on one
side of the body, numbness, speech difficulties, and visual loss. Most TIA's
will resolve within an hour or two, though the criteria states 24 hours.
TIA's are of concern as they may herald a pending stroke at some point in
the future. The issue then becomes prevention.

Whether your mother had a TIA or not is unclear. It may have been the medication,
a vaso-vagal reaction from using the toilet, or she simply stood up too fast
and got lightheaded. The history that your mother was slurring her words,
however, is more suggestive for TIA. The point is that there are many things
that can cause an elderly person to fall and present like this to an emergency
room. Even so, your concerns are valid.

You might consider contacting your mother's primary care physician to see
whether she has had a recent evaluation. The usual risk factors for stroke
should be assessed and her physician may choose to evaluate the carotids with
an ultrasound examination if it has not been done recently. If no surgical
condition is found (e.g. tight carotid stenosis), the physician may choose
to increase the dosage of aspirin or switch to another medication such as
ticlid. Again, the issue is prevention, and the best place to start is with
your mother's primary physician.

Good luck.

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