This is a difficult problem. For our other readers, a transient ischemic attack (TIA) is a brief, reversible neurologic event like a stroke, but the effects do not last more than 24 hours. There has been a fair bit of adult literature suggesting that a patent foramen ovale (PFO), which is a small hole between the upper two chambers of the heart that all babies have in utero, and is still present in 25% of all adults, may be allowing a blood clot to pass through from the right to the left side of the heart. This would then supposedly cause a neurologic event. Thus, there has been a lot of talk about performing a cardiac catheterization and placing a device in the PFO to plug it. However, the literature supporting this is not strong, and is even less so in pediatric patients. In fact, there have been a couple of well done recent studies that say that there is no difference. Therefore, it would be more important to make sure that the blood vessels in the head and neck are normal, and that your son does not have a clotting disorder. Without evaluating your son, I cannot say for sure what it is causing this. However, it would be important to have him evaluated in a center that is used to evaluating specifically children who have these events.
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