Can I prove I didn't have a TIA?

[imajoker2]

I was involved in a low speed accident with no apparent injuries.  The following day my left arm went weak and I visited the ER suspecting a heart attack.  After all the tests
including a brain scan with dye, (I had melanoma) I was discharged with a probable pinched nerve.  A follow up MRI shows
central disc herniation with focal dural sac compression C3-C4, which I read is a rare injury.  Since the initial occurance, the left arm weakness is gone, however I am experiencing a variety of other symptoms such as neck stiffness, crunching sounds when I move my neck, different pains at different times in my face and back.  I also have a sense of pressure on the back of my neck and headaches, not bad but I know they are there.  I also get little tinglely things running up the back of my neck and head.  The most disturbing symptom is the "feeling" off balance for lack of a better description.  I have never felt like I was going to pass out or fall over, just that feeling that something just isn't right.  I have an appointment with a neurologist set up later this month, but the symptoms are not going away and I wonder if something else isn't going on.  I have a two part question.  (1) Are the symptoms described consistent with the type of injury in the MRI?  (2) I am a professional driver.  The company doctor is convinced I had a TIA, causing the minor accident, and has stated I must prove I didn't have a TIA to be allowed to go back to work. I never had any of the classic symptoms of ever having a TIA.  If TIA's leave no evidence of occurance how can I prove I didn't have one?

[CCF-Neuro-M.D.-JT]

1)Would have to look at the scans myself, but yes the symptoms could be caused by the cervical disc problem. In addition to the crunching, pain, and tingling which is more readily linkable to the disc problem, there is an entity called cervicogenic vertigo which is dizziness caused by disc disease (usually from trauma).
2) The clinical history surrounding the accident, your neuro exam, and the presence/absence of any stroke risk factors (such as prior stroke, heart disease, cholesterol problems, smoking, and diabetes) as well as a normal MRI fo the brain that shows no evidence for cerebrovascular disease can be used to support or refute the possibility of you having had a TIA. If everything is clean,then it is unlikely you had a TIA out of the blue. This should be something your neurologist can help you with. GOod luck

[AnnaFrank]

The following is from Mayo Clinic:  

"TIAs typically last from 2 to 30 minutes.  All effects disappear within 24 hours. TIA signs and symptoms resemble those found early in a stroke and may include:

Sudden weakness, an abnormal feeling, or paralysis in your face, arm or leg, typically on one side of your body; slurred or garbled speech or difficulty understanding others; sudden blindness in part of your visual field, sometimes as if a gray or black curtain is falling over or crossing your visual field; dizziness, loss of balance or loss of coordination."

My husband has a history of stroke/TIAs.  I took him to the ER last year when he experienced numbness in his leg.  The doctors there insisted that it was a TIA.  However, the tests they ran did not confirm this.  They sent him home and told us to make an appointment to see his neurologist. However, no one in the ER would listen to me when I said that we thought his problem had to do with that surgery.  I kept trying to get them to do an ultrasound, etc., of his abdominal region. They kept focusing on the fact that he had a history of stroke -- and assumed that he had experienced another one.

When we saw his neurologist a few days later, the symptoms were still there.  He ran tests, including a carotid doppler and MRI. He told us that it wasn't a mini-stroke because the symptoms would have disappeared by then. It turned out to be a blocked artery (he has an implant due to an abdominal aortic aneurysm). The neurologist sent us back to my husband's vascular surgeon. He wouldn't run any abdominal-related tests on him since he felt that the surgeon would end up ordering his own tests (they work at different hospitals).

I think that your neurologist should be able to provide evidence that it wasn't a TIA, based on your ongoing symptoms.  The other specialist should be able to confirm the source of your problem.

[Hook]

I was also in a car accident from which I suffered a disc herniation.   However, my disc level was c6-c7.  I did have similar symptoms as yours.  Left side weakness.  Most intense was pain in my left shoulder.   Alot of referred pain from the neck is between the shoulder blades and weakness to the involved nerve root.  I had severe cracking sounds in the neck with horrible headaches.  Since the fusion I have never had another headache like I did before the fusion.  It helped alot. It also somtimes helps to keep a daily journal before seeing the doctor so he can really get a good idea of what you have been experiencing. If I have learned anything about my 2 1/2 years of doctors and surgeries is that, you have to be educated on your symptoms and be proactive in your treatment.  What you may think are weird occurances could really prove to be a clue in your diagnosis.  Best of Luck to you.

[AnnaFrank]

When I referred to other specialist, I meant to say that you'd probably benefit from seeing an orthopedic specialist, if you haven't already.  They would be able to provide you with an accurate diagnosis.