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Multiple unknown origin TIAs/mini strokes

My 53 year old husband is having 2-3 weekly TIAs or mini-strokes -- these always affect the right side of his body with facial numbness, eyelid drooping, difficulty swallowing and trouble walking straight - most times, but not always, also with an instant headache and perfuse sweating.  These first started 6 months ago - he had not been seen by a doctor for over 10 years prior - during the initial work up it was discovered an abnormal EKG which lead to stress test which led to cardiac cath and discovery of the need for quadruple bypass with worst blockage in the left main.  This was done 5 months ago and recovery has been great -- back to playing racquetball and archery hunting - heart showed no disease, etc. - still having the TIAs however!  Fortunately, we are not seeing any lasting cognitive or motor problems from these episodes.  MRI, MRA everything is showing up negative.  Carotids look clear.  Bloodwork shows all is good and BP is under control.  24 hour urine test for chemicals indicating a brain tumor was negative across the board.  Taking Plavix, Lipitor, Aspirin, Ramipril and fish oil with no side effects.  TIAs usually last 20-30 minutes.  The one this morning lasted nearly two hours and landed us in the ER although it was over by the time we got there and were seen.  They could find nothing that should be causing it - heart, BP, everything was normal.  We saw one neurologist who, after a 5 minute visit, said it was hardening of the arteries in the brain and we were doing the only thing we could with the meds.  Where to go now -- second opinion from a neurologist at a teaching/research hospital (we have one nearby)?  Our primary care doc has been great in working with us to solve the problem knowing we do not want to accept we have to live with these until a major stroke comes along but she is running out of ideas of what it could be.  On the one hand, we feel very fortunate the heart blockages were discovered and reparied before a major heart attack but the original problem of the TIAs/min-strokes still exists -- appreciate any and all experience or advice!
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Avatar universal
As an update to my post - fyi - after seeing a stroke specialist, my husband is now on Cardizem (Dialtiazem ER) and these episodes are being controlled - he can still feel them starting for a few seconds but then they seem to shut down - possible vacular spasms or something similar is what has been diagnosed - no definitive test is available to be sure.  We are blessed to have found a way to control these to some degree - never give up trying.
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