Newbie Question about TIA and Spinal Tap

[Jitterbuggin]

I have been going through neurological testing for symptoms that were accidently discovered as a result of an exam due to an auto accident last August.  So far they have found hyper-reflexes (most times a 4 or 5) ankle clonus in both ankles, and some other positive reflex tests.  I had MRI's of my spine, neck and brain.  The Dr. said he was surprised he didn't see lesions on the brain MRI since he was thinking I have MS.  He did find extreme cervical narrowing around the spinal cord in my neck and it looks like 2 discs were bulging and pressing on or near the spinal cord.  This Dr. sends me to a neurosurgeon who wanted me to have a spinal tap and a myleogram to see if surgery was needed for my neck, but he said the narrowing in this area wouldn't cause my neurological symptoms, those were most likely from a disease (maybe MS)  Anyway, about 2 hours after the spinal tap/myelogram I ended up in the emergency room with what they are telling me is a TIA, a mini-stroke.  After 2 nights in the hospital and an exam of my caratoid arteries, an echo cardiogram, CT scan and another brain MRI, they gave me no results, but sent me home and told me to see my primary care doctor this coming Monday to get my results.  They also said the spinal tap/myelogram procedure was not related at all to the TIA.  I have a hard time understanding that this would somehow be such a coincidence.  My TIA symptom was I woke from a short nap and my speech was slurred and I had a hard time structuring sentences and findng the right words.  This only lasted a few hours and I returned to normal within 24 hours.  The second day prior to the MRI, I requested some sort of sedation since I am extremely afraid of small spaces and they gave me something by IV.  I was awake during the entire procedure, but after the procedure, my friend told my my right eye was drooping, and I made no sense, babbled a lot, and changed the direction of my conversation with her about 12 times in one sentence!  This really worried her.  I guess this post would worry her too! LOL  Sorry about the length of the post...I was just wondering if any of you have had any similar experiences or have any advice

[catsw64]

I recently had an MRI of my brain and was told that I have small vessel disease of the brain.  I was diagnosed with it ...AFTER I Moved into my apt. that I've discovered has mold growing in my bathroom wall.  There was a bad leak two years ago upstairs after a dog chewed a pipe into.  Then, shortly after, a pink and black stain showed up on my wall as if it had already been painted over once or twice..who really knows.  I also have severe nerve damage and my dr. or dr.'s, can't figure out why I have all of this going on.  I've never had anykind of head injury, car accident, fall, lick to the head, nothing to explain it just ....ALL OF A SUDDEN showing up at age 45....  they say also that I have what you call, "Old Brain", meaning I have the brain of a 73 year old woman.....

any clues???????

[Jitterbuggin]

Wow, thanks for all the help with this.  Today I saw my primary care doc for all the test results from the hospital.  She told me I didn't have a stroke, but possibly a TIA, but there was no way to confirm it because my tests were negative (I'm not sure what test..) anyway, the coratid artery study showed no blockage, and the echo cardogram showed a mild backwash (my words) near a valve...nothing to worry about she said.  She also said I had something like small vessel disease of the brain...basically the smaller vessels start to constrict as they do with age and that could cause some memory problems, but again she wasn't concerned as it was very common (i'm 57 but got the feeling it was a little more advanced than it should be for my age..

As far as all the labwork on all my vitamin/mineral levels...they weren't back yet, nor was my spinal fluid test.  So no news on that front.  She did mention a small T2 something on the brain mri, which did not concern her.  I explained that 2 of the specialists were thinking maybe MS and she right away told me you don't have to have lesions on the brain mri to have MS, it can be on your spinal cord, so the labs will be helpful.

I go back to the neurosurgeon on 2/2, and the neurologist on 2/17 and they are calling me to set up the appointment for the sleep doctor.  I aknow it's time to get this all re-evaluated since I've lost 75 lbs.  I know I am sleep deprived but I am soooooo wound up.  It's really hard for me to relax.  I may start having 1/2 glass of wine at night to see if that helps....I'll wait for the doctor's recomendation first. LOL

I may have some central nervous system apnea which means I will still need the cpap (or bi-pap) and once I have sleep studies done for the apnea, then I'll worry about the restless legs.  I just think if I start sleeping I will feel soo much better.

I want to thank everyone for your comments and suggestions since this is a new journey for me, whether I have MS or not.  It's quite a process to even get a diagnosis.  I really empathize with what you are all dealing with.  I'll keep you posted after the labs come in, but in the meantime, feel free to comment, especially if you know what T2 thing she was talking about on the MRI.  I brought my daughter to the exam,,,,maybe she can remember...the doctor was good, but spoke pretty fast and it seemed clear when she told me....then I went and left the office....duh   LOL

[biowham]

Jitter, the CSF doesn't really influence the blood volume or arterial plaques with that kind of interaction of a draw of CSF triggering some sort of embolic/thrombotic event. Could've been some stress-related blood pressure boost/endothelial tension that caused something to break loose? Dunno. Seems like also I remember that there will be transient (um, duh?) evidence of a TIA but that it would not persist for longer than a few weeks on MRI? Can't for the life of me remember where or in what context I might have read that. At any rate, in the moment like that, an MRI should have shown any TIA event, unless you somehow pulled up a false-negative result.

Bio

[Jitterbuggin]

I may have been mistaken when I wrote that  TIA's don't show up on MRI's....that's just what I thought I read, but with all I've been through the past few days, my data could be as fuzzy as I am! LOL!   It will be interesting to ask the questions Monday about what shows up on an MRI, and the zillion other questions I have.

I take blood pressure medicine, and it has been controlled pretty well, but sometimes on the edge of being low.  My blood sugars are good, my diet isn't high in fats, mainly high protein and low glycemic carbs.  I also have pretty good cholesterol levels but am taking a statin drug to increase my good cholesterol.  

I'm wondering if the process of withdrawing fluid from my spine and injecting dye might have broken off some plaque that went to my brain????  Oh well, I wish I had more faith in the medical community.  I'm sure that whatever I hear on Monday will leave me with more questions than answers.

[essdipity]

I'm wondering if TIAs as a possible diagnosis isn't an example of backwards reasoning. Here's what I mean.

A person gets a brain MRI because of MS-like symptoms. Surprise, the MRI is abnormal. But it doesn't fit the mold too well, so the radiologist suggests microvascular ischemic disease (ESPECIALLY if the patient is past youth, and almost always if he or she is relatively ancient). From what I have read, this kind of ischemia occurs in tiny veins in the brain, maybe elsewhere too, and is essentially harmless. But how to explain this possible result? Why a series of TIAs, of course.

No matter that the person has no history to suggest strokes, has ideal blood pressure, and even underwent carotid artery ultrasound, which came out just fine. It's a way of explaining the MRI, without reference to any symptoms, tests or examination.

Guess who this patient is? Yup, me. For at least 5 years, a few neuros and several MRIs.

From what I've read and what Quix has said, it actually is pretty common for 'white spots' to form in the brains of some people as they age. A tiny percentage in their 40s, and more as time passes. Usually these people don't get brain MRIs, and live happily and healthily, if not forever, then for a long time. If they do get an MRI and have no neurological symptoms, they could be like Lulu's mom(?) and something else is wrong.

I'm not sure whether TIAs are seen as permanent, but I'm guessing they are, since major strokes are. Hope someone knowledgeable will jump in here.

What infuriates me is when vascular disease is used to explain away abnormal brain MRIs in the absence of that kind of symptom and in the presence of lots of MS ones, all because of the good ol' aging process.

ess

[rendean]

Lulu,
Please share what information you find about the TIAs and signs of same on an MRI. They claim some of my white spots are from possible TIAs. I would be very interested in what you find. Currrently, I am so tired, just woke up from a 17 hour sleep, I'm not sure when I'll have time to look but will share whatever I find.

Dr. Kantor answered my questions (most) but left me with more .so... Guess I'll start asking the "experts" from here with on the job experience until my next (new) neuro appointment.

Rendean

[biowham]

I'm wondering if you really had a TIA. Did they mention having confirmed that, or just basing it on your symptoms? I guess we need to wait to see what you learn on Monday.

Bio

[Lulu54]

hmmm... my mom had a serve case of vertigo a few years back and the doctors did an MRI. they told her she had multiple white marks on her brain which they said were attributable to many tia's.  I have long wondered if perhaps she doesn't have MS - too many of her symptoms fit the big picture.  Now  you're saying TIA's don't leave marks- that gives me something else to research.  

We'll watch for your answers on Monday.  And yes, it does take tons of patience to be an ms patient.
cheers,
Lulu

[Jitterbuggin]

Thanks for the reply.  They did the 2nd MRI based on the TIA.  The first MRI didn't show lesions. Since I don't know yet what the 2nd MRI shows, I'm really in the dark.  I've read that TIA's don't show up on an MRI because they don't do permanent damage.  I'm really wondering if I had a TIA or if that is just what they think based on my symptoms.  Monday seems soooooo long away.  I'm not a patient person, but after reading all the posts on this site, this is something you have to learn to be with MS.  I'll keep you posted on what I find out.

thanks again,
Jitterbuggin

[Lulu54]

Hi JB, Welcome to this forum - there are lots of very knowledgable medical consumers here who may be able to help you with this question.  I don't know that I have ever heard of a TIA occuring because of an LP.  I guess it could be a coincidence that it happened around the same time frame as your LP.  

Did they do another MRI to dx the TIA or were they just going from your symptoms?  If you had someone in a hurry or not knowing how to read an MRI it could be possible that the TIA was misidentified and could be a lesion.  

Please let us know what your primary doctor says this week.

my best,
Lulu