Re: Stroke?

Posted By Henry LIM on November 17, 1997 at 20:23:08:

In Reply to: Re: Stroke? posted by CCF Neurology MD on November 13, 1997 at 16:37:23:







: : I had the sudden onset of neurological symptoms on Feb. 17, 1997 following pain in the upper right
I had almost similar experience described by this patient. I am male Chinese aged 48yo on
treatment for hypertension for 1 yr with zestril and pravachol. Had experienced
one episode of weakness in lower right arm for 2 mins middle of night. Had
CT brain scan,carotid artery, ECG - all normal. However, MRI brain scan
did show some "signs" at left cerebral area which my neurologist said explains
the weakness but does not suggest a brain lesion or damage. On 300mg aspirin
since then. Dr also said that he would not certify me as having had a TIA
for purpose of medical/life insurance. If so, why am I still on aspirin and
gingko? Please enlighten me as I don't feel comfortable questioning my dr.
of my back. It progressed gradually until the 17th when suddenly it was
painful to just breath. My hands were tingling and I wasn't able to tie my
shoes or sign my name properly at the E.R. I was diagnosed with Pleurisy.
After several weeks of "strange" weakness and tingling I went to see a Neurologist who tested for
possible M.S. MRI of the brain and spine, Spinal Tap and Evoked Response tests all
of which were normal. She referred my to a cardiologist who suspected a
possible embolic episode. He then referred me to another Neurologist the
"top gun" at Beaumont Hospital in Royal Oak, Mi. He examined me and found
an obvious weakness in my left arm and the left side of my face. He is convinced
I had a small stroke (not a T.I.A.) due to a blood clot (somewhere). I had
a T.E.E. with no obvious sign of the embolism. Throughout the month of August
I noticed complete restoration of strength in my left arm. My other chief complaint
is fatigue. This symptom has been there ever since Feb. 17th. Some days
are worse than others but upon ANY physical activity, I'm gassed! (I'm 43 years
old). He along with my cardiologist decided to place me on anticoagulants.
I've been taking Coumidin for almost a week now.
My questions are: is there any specific test for a stroke due to a blood clot?
Could they just be "fishing" and maybe theirs another problem such as M.S.?
I was also tested for possible Lupus and the blood tests were negative?
In addition to the fatigue, I have muscle spasms (only when laying down) in my
left leg and just recently have been experiencing them in my hands and forearms.
I occasionally have minor pain in the back of my neck.
Thank You so much for your time.



=
Dear MG:
The description of your initial symptoms is far from typical of a stroke. It seems to be more suggestive of a nerve root problem in the neck, from compression or otherwise. However, the fact that you have seen multiple specialists probably implies that you have a difficult diagnostic problem. I do not think I can answer any of your questions with any accuracy without actually getting to see you and reviewing your records. My only comment is that it can be quite dangerous to take coumadin if it is prescribed without a well-defined, identified indication or diagnosis.
While you may take coumadin as advised at this time, it is really important that you seek another very competent neurology opinion relatively urgently. I can strongly recommend Dr. Furlan, Dr. Sila, and Dr. Hinchey at the Cleveland Clinic for such an opinion. Each of them is a nationally renowned neurologist with special expertise in stroke, who, I am sure, can resolve the diagnostic difficulties of your case, and conclusively advice you about the most appropriate treatment.
The number to call for appointments is [phone] toll-free, or [phone] locally.
Good luck.