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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: left vertebral Artery occlusion, corrective therapyForum: Neurology Forum
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Two years ago I was diagnosed by my family physician (internist),with high blood pressure and classical migrane syndrom, (with visual auras). He put me on BP medicine (toprol, 50mg/day) and referred me to a neurologist to address the migranes. I had a CT scan and it showed only mild calcification normal to my age of 50. His recomendation was to take enteric coated asprin (325mg/day with vitamin E, 400IUD/DAY). Now about 2 years later, last January I had what I called an intermittant bruie in the left side of my head. I saw the internist and he dismissed it as non life threating or serious. About a about 2 months later it disappeared all together. In mid April, I started to get frequent events of diplopia (3-4 times/week). In May, I went back to the internist, and he diagnosed me with high blood pressure again. He then put me on another BP medicine (Cardura 2mg/day) because I was also complaining of what was thought to be bladder or prostate pain. This other medicine controlled the BP and the incidence of the diplopia subsided to 1 event/week. Since I still had mild events of diplopia (15sec to 3min durations 1 time a week, I was sent back to the neurologist. He did an Ultrasonic doppler test on my vertebral arteries and the bascilar artery. His findings were that the left vertebral artery was occluded; and the right was ok as well as the bascilar. He noted that the flow at the basilar was reduced or below the expected level. Also, He noted that when I move my head/neck, that flow decreases in various positions. His diagnosis was that a preventive therapy of Ticlid 250mg/day added to the same 325mg of enteric asprin be instituted. 1st Question: Is why would not a more aggressive approach with heparin be instituted to try to open the Left vertebral artery (in the event it was a platlet/blood cell type clot)?. He says He thinks it is a fatty plaque type. 2nd Question:Would It not be a more prudent approach to address the current occlusion with heparin or etc. in the event it is not a fatty plaque type blockage, but a blood clot???. Now what also concerns me is an injury that I obtained when I was in high school (about 32 years ago). While shotputting I strained and snapped my neck. At that time I sought no medical assistance. It took over a month before the pain subsided. Since that period of time I always have a feeling of a tightened neck, and I constantly stretch it with head jerks to relieve the tightness. I believe over 32 years of doing this, may have resulted in damaging the vertebrae and possibly contributed to damaging the left vetebral artery via vetebrae misalignment or arthritic bone growth. My last question is, do you think that I need to pursue an investigation further than the doppler test to address possible physical damage???. ___ ___ Hi RS, An occluded vertebral artery is not uncommon in someone your age and is generally The pressing issue at this time is your episodes of double vision and stroke A second opinion may be sought at the Cleveland Clinic in the Department of Good luck.
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