Post TIA Problems.

[Mike]

I am a 36 year old male, previously very healthy.  3 months ago I had a TIA affecting my right perifial vision. Most of the vision returned after a few hours but I am still left with a good sized blind spot. After an ultrasound and angiogram it was determined that the TIA was caused by a Left Carotid artery dissection around 70% blocked.  My doc's decided to put me on warfarin and let the artery heal itself.  I had no problems for 2 months.  I then had an episode where I became extreamly lightheaded,  it would come and go many times throught the day.  It lasted for about a week and slowly resolved.  3 weeks after that I had another episode of much the same thing however this time I had cold waves going through my right arm and muscle stiffness in my right hand and later through both arms and feet. The doc's put me on neurotin which did little to help.  After about a week it began to go away however it left my arms very weak and my right arm sore and stiff.  I am still having small epsisodes of the cold waves and stiffness in my right arm.  My Artery has opened to about 60% but do you think that the episodes could be related? Or maybee caused by the TIA?  I am very concerned that I may be developing something more serious like MS or something?

[CCF Neuro[P] MD, RPS]

Dear Robert:

It is impossible to tell you for sure.  The TIAs were likely due to your surgery and the arrhymthias induced by the surgery.  Since you have had a pacemaker, this sould be resolved as far as the A-Fib is concerned.  However, there is a possibility that there are other reasons for your TIAs, such as hypertension, high cholesterol, etc.  I would just make sure that all is well, a thorough checkup and clearance from you cardiologist is a good idea.  This this clearance, I would think that things would be okay and your chances of having another TIA would go way down.

Sincerely,

CCF Neuro MD

[robert lowe]

I
had aortic root and valve replacement with a mechancial prosthetic valve and associated dysrhthmia. After this operation I needed A pace maker. I have been having tias about 6 times in the last three months. The last one lasted about 5 minites it was always in my right eye. The vision was like a dark cloud came over my eye; but I could see throu the middle. I drive a city bus and the D.O.T. won't let me drive a bus any more. It's been about three months since the last TIA. iS THEIR A GOOD CHANCE I am over them?    

[robert lowe]

I
had aortic root and valve replacement witha mechancial prosthetic valve and associated dysrhthmia. After this operation I needed A pace maker. I have been having tias about 6 times in the laste three months. The last one lasted about 2 mimites it was always in my left eye. The vision was like a dark cloud came over my eye ;but I could see throu the middle.

[CCF Neuro[P] MD, RPS]

Dear Mike:

There are many possibilities and without examining you or seeing the labs it does not narrow down the possibilites for you.  Your symptoms could be anything from a stroke to a peripheral neuropathy.  There may be metabolic problem or genetic problems that could be giving problems.  Since you are still a very young man but you have a dissection of your carotid, this is unusual.  I would think that trauma, vasculitis, lipid problem, high blood pressure, medications or drugs etc could play a role.  Again, I do not believe you had a TIA as your symptoms are persistent.  It is more likely that you had a small stroke.

Sincerely,

CCF Neuro MD

[Mike.]

Dr:

Thanks for the input.

The earliest that I can get in to see a Specialist in Neurology is May 26. What are some of the possibilites that could cause the symptoms that I have described? I have never experienced any of these types of problems before the Arterial dissection/TIA.

[CCF Neuro[P] MD, RPS]

Dear Mike:

I think I would talk to your doctor.  TIA's do not leave a residual deficit and your symptoms may be something other than what is being treated by neurontin. I would try and fully evaluate whether something else is going on, at least from what describe.  It would be very, very unusual to develop something like MS, especially with left sided brain and right sided symptoms.

Sincerely,

CCF Neuro MD