Posted By kd on April 30, 1999 at 09:40:03
Hi. Thanks for this opportunity. As you can see, I have a couple of different questions.
1. I have a hx of classical migraine. I also have a left common cartoid that
is completely occluded after carotid endarterectomy/carotid-aortic graft. Dopplars show that the right common, external, and internal carotids are becoming occluded to the extent that surgery was being considered. I was sent to a neurologist after some apparent TIAs. The neurologist said that the results of the dopplar were most likely highly inflated due to the occlusion of the left common; that the right side formed a collateral to the left side and the pressure of the blood was changed by the constriction on the left side, creating a greater pressure on the right and changed dopplar scores. I know from MRA that the right side flow is most responsible for flow in the left side Circle of Willis but there is nothing showing a connection between carotids peripherally. The L external does feed the internal from a collateral but ...
? Does the neurologist's conclusion make sense?
2. She also said that I am at very low risk of TIA/Stroke and should not consider my "episodes" as TIA but as migraine variant. The problem I have with this is that when I have a migraine (I've had them for 40 yrs.) and when I have an "episode" they are very different. They are different in the type and duration of visual aura. If there is headache, they are different in type of headache. If there is numbness, the duration is different. On occasion, I will have a migraine that pretty much resolves when one of these other episodes hit. However, I have always had a migraine before something else major hit - like appendicitis, ischemic colitis, a TIA just prior to the endartarectomy, etc.
? Can you have more than one type of migraine in at a time.
I have been dxd with TIA/RIND before but because there is nothing showing on the MRI, she says they were really migraine variant.
? Do TIAs always show on MRIs?
I had a diamox spect test a couple of years back and it showed a fixed defecit in the watershed area and a mild transient problem that has since resolved. These areas did not show on the MRIs. I have residual problems from that but she says it is the result of the carotid occlusion and should not be considered TIA/stroke. (I have doubts about this, too, because of timing factors.)
3. Do MRIs and MRAs always pick up the amount of plaque in the artery?
4. My father recently had what is diagnosed as a hemorrhagic basal ganglion stroke caused by high blood pressure. He is 76. He was released from the hospital before he was given instructions, etc. and the hospital has not forwarded his reports to the PCP. His speech and writing skills were affected, as well as walking (for a brief time). He is being told no driving, working in the yard, or in the garden (He's a "farmer" and also likes to work in their woods.) Is there anything you can tell me about this? They say his BP has to come down (approx. 140s-150s/90s to peaks at 101) before he is able to do anything but the inactivity is driving him "crazy".
5. Last one: Can Mitral Valve Prolapse and/or high systolic blood pressure cause plaque formation in other parts of the body ? Is it possible that the peripheral vascular disease that I have is coming from those issues?
Thanks so much,
I've been waiting for months to ask and the questions started piling up.
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