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TIA and diagnosis

      Re: TIA and diagnosis

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Posted by CCF Neuro MD# on March 19, 1998 at 19:01:21:

In Reply to: TIA and diagnosis posted by mariette on March 19, 1998 at 18:19:05:

: Good morning!
  I have a question re. TIa's. Since 1990 I have trouble with clotting and take daily coumadin dosage to remain within optimal INR range. I also have problems with bloodvessels and heart. Actually I have a question re. TIA's.
  Question 1: is a TIA always caused by a clot? What about a sprung small bloodvessel? Could it close by itslef again? Is this also called a TIA?
  Question 2: how is a TIA diagnosed? Since it obviously disappears after a while, how can they diagnose afterwards?
  Question 3: what are the exact symptoms of a TIA? I really mean: when do you have to see a doc?
  Question 4: should you really see a doc?
  Question 5: how long do the symptoms last normally?
  These questions may seem weird, but I actually think that I had (sort of?) a TIA. I checked the symptoms in the AHA A-Z guide and it was almost similar. But I just thought: what is the point of going to a doctor if it is gone..... I am not really into the doc stuff anymore... They made mistakes in the past... So, I hope you could help me out with this matter. Is it dangerous at all? Could it happen again?
  Thanks very much for your reply! I hope you can help me.
Taking your questions one at a time :
TIA's are generally caused by clots , the mechanism you mention is theoretically
possible but would be impossible to prove, this is probably the mechanism
underlying the transient neurological defecits which sometimes accompany
migraine attacks.
TIAs are diagnosed on the basis of the history given by the patient,in the context
of typical risk factors or evidence of predisposing illnesses like atherasclerosis
or heart disease, sometimes the doctor may witness an atack if they are occcurring
very frequently but this is quite rare.
There are no exact symptoms since many TIAs are silent and the symptoms depend on which tiny
vessel in the brain is affected.
Typical symptoms include transient speech difficulty, weakness on one side,
or loss of vision in one eye.
As regards seeing a doctor, A doctor is obviously the wrong person to ask,
since you can predict the response in advance ! However since a TIA is often
a warning of serious arterial; disaese which could progress to full blown
stroke I would suggest it is a good idea.
The textbook definition of a TIA is that it is a deficit that clears within
24 hours but in practice most resolve within 20 to 30 minutes.

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