Q: I am a 79-year-old female. Three months ago I experienced what may have been a TIA. That is, I was unable to pick up a cup or plate, unable to speak, and feeling faint. It lasted only a few minutes. It has left me with very minimal dull headaches and feeling weak. I do not have a doctor but feel I should have a checkup. What kind of medical help should I seek?
A: A TIA (transient ischemic attack) is referred to as a mini-stroke. It is similar to a stroke but may last only a few minutes and will disappear without any permanent damage. Almost one in every three individuals who experience a TIA will go on to have a stroke that commonly occurs within a year of the TIA.
Symptoms may include slurred speech, dizziness, a loss of balance, and numbness/weakness/paralysis of the face or extremities that presents on one side of the body only. A TIA may dissipate within about an hour following an attack but it is a reversible event that leaves no tissue damage, yet some of the events have been known to cause subtle brain changes. Because more than on TIA can occur, the signs and symptoms may vary depending on the specific area of brain involvement.
A TIA or stroke occurs because of a buildup of fatty deposits known as plaque in an artery or one of its branches that supply nutrients and oxygen to the brain. The presence of plaque can diminish the flow of blood through an artery and lead to the development of a clot. Or, a blood clot may move from any area of the body such as the heart to the brain.
There are some considerations over which we have no control when it comes to having a TIA or stroke. They include aging, a family history, gender (with males having a higher possibility of development than do women), and race. African Americans are at greater risk of development than are Caucasians. Fortunately, there are some factors over which we can have some control. High blood pressure can be controlled through a number of methods, including medication. Foods high in fat can be avoided, as can those with a high sodium content. Smoking can increase a person’s risk of developing a clot. And it can also elevate blood pressure levels, so discontinuing the habit is important. Making better dietary choices and reducing your intake of saturated fats and trans fats may also go a long way toward reducing arterial plaque buildups. Regular exercise can help reduce body fat but any regimen should be discussed with a health care professional before it is actually begun.
Diagnosis of a TIA may be difficult, essentially because unless an individual visits an emergency room immediately following the attack, the diagnosis can only be based on the medical history given. Therefore, even at the young age of 79, you should have a primary care physician and some baseline information on file. He or she will listen to your medical history (or lack thereof), perform a complete examination, listen to your heart, perform an EKG, and order laboratory testing. Depending on the history and physical exam, other possible testing might be a carotid ultrasound, a CTA (computerized tomography angiography), transthoracic echocardiogram, or other testing.
If your physician feels you may have had a TIA, the next step is to prevent a stroke from occurring. This may include a prescription anti-coagulant or anti-platelet drugs. The medication prescribed will depend on the location, cause and severity of the TIA.
I feel as though I’m suggesting you lock the gate after the cows get out but you should make an appointment with a general practitioner now, before allowing sufficient time to lapse and another situation to occur. Explain what has happened, undergo appropriate testing, and take steps to do whatever may be necessary to avoid a future incident.
Readers who would like more information can order Dr. Gott’s Health Report “Stroke” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order payable to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
