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TIA's in otherwise healthy male 15 years apart?

      Re: TIA's in otherwise healthy male 15 years apart?

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Posted by CCF Neuro MD on June 13, 1997 at 12:31:12:

In Reply to: TIA's in otherwise healthy male 15 years apart? posted by Evelyn Koch RN on June 07, 1997 at 17:25:16:

: This seems bizarre to me, but was wondering if any MD's could come up with an explanation for these symptoms........Approx. 15-16 years ago, a friend of mine, not particularly atheletic, attempted to snow ski for the first time.  Here in so. California, he ascended to Mt. Baldy, (an altitude of Approx. 8000 feet), and after a period of vigorous exercise, developed an extremely severe headache, (no doubt a symptom of altitude sickness).  However, upon return to his baseline altitude he developed an inability to speak which lasted for approx. 20 min.  A CT and other tests at his local HMO were all normal and the explanation for his symptoms  was given as a transient "brain anoxia" brought on by the altitude and activity.  He had no other symptoms but the speech loss.  Then, approx. 6 weeks ago, (he is now 46), after lunch on a day that was quiet and uneventful, he lost "focus" in is right eye which seemed to him initially due to dirty eyeglasses.  He had a mild headache at that time.  His symptoms then progressed to tingling and numness on the right side of his face including his mouth and tongue.  After an additional 5 minutes, the numbness and tingling extended to his right arm and leg, but without any motor impairment, in fact, he was able to drive himself to his HMO using a stick shift.  However, instead of a speech loss, he found that he was unable to formulate complicated thoughts, or as he describes it......."use big words".  He "felt dumb", whereas 15 years ago he was unable to speak.  CT and other tests were "normal" for that episode also.  I am concerned for him, and was wondering if there  could there be some potential underlying neuro or vacsular condition that might be sending out early warning signs or if there are other diagnostic tests that are more difinitive.  Are these incidents completely unrelated?  Any potential link between seemingly different symptoms?  Any response from neurologists would be appreciated.  My background is in Critical Care and I work in an ICU at a USC affiliated hospital, so if anyone feels a referral or a particular test might be helpful, I can probably refer my friend to the appropriate hosp/physician.        Thanks
Hello Evelyn,

I have not heard or found any reported cases of altitude sickness resulting in stroke like symptoms.  The symptoms that your friend has experiencing is certainly concerning.  These symptoms seem to represent a stroke-like event especially the more recent symptom of change of vision in one eye and numbness.  The other possibilities are that they may have represented a complicated migraine headaches or less likely, a seizure.  As you can see the differential is quite varied and your friend needs an evaluation by a neurologist.  The symptom of sudden change in vision in one eye is worrisome in that it may represent a TIA (transient ischemic attack).  The most common source for these symptoms are from a blocked carotid artery.  This can be evaluated by a carotid ultrasound or an arteriogram if necessary.  I am not certain whether his current symptoms are related in some way to what he experienced while mountain climbing.  I wish you the best luck on finding the cause for friend
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