Transient ischaemic Attack (Tia) Mini Stroke

[oncearugge]

I too question the LP, usually done only when intracranial bleeding or infection are suspected to have caused the hydrocephalus neither of which seems likely in your case (the imaging would have ruled out a bleed, and you have no symptoms suggestive of infection).

Also question the MRA of the chest.

You need to be careful you are not being subject to excessive and unnecessary tests. Known to happen.

For the chest 2 Singaporean Neurologists suggested the TIAs could be caused by damaged or hardened Arteries. My old man had his first attack on Angina at 40 years old. I Have the resources to be to able to undertake most tests they feel are adequate. I don't sit there worrying thinking ohhhh I spent 2 Grand , I'm relieved I've not got a tumor or cancer and I've not just seen my wife and kids for the last time, If I'm going to "Spend" Money I'd rather do it taking care of myself than some stupid 20 K car or ridiculous over priced ex-council house. It seems the accumulation of money for the kids "Futures" is all what life is about , how about taking care of yourself and "Spending"" dough on that so you are around when they have their kids. I will not agree to the suggestion I am being Naïve. I suppose I could have spent the money on 2 weeks in Magaluff. If you are British as I am , I think we take free Government treatment for granted as we do with all government "Services"

No one is suggesting that you should not expend resource on securing health care.

What is being suggested is that you ensure you are informed adequately about the need and reasons for, any investigation and treatment.

If you are happy with the explanations provided and understand what you are consenting to then fine if not then seeking a second opinion would be wise

Over-investigation / treatment of medical conditions is a well researched fact which affects some health care systems more than others.

[This Thing of Darkness]

I too question the LP, usually done only when intracranial bleeding or infection are suspected to have caused the hydrocephalus neither of which seems likely in your case (the imaging would have ruled out a bleed, and you have no symptoms suggestive of infection).

Also question the MRA of the chest.

You need to be careful you are not being subject to excessive and unnecessary tests. Known to happen.

For the chest 2 Singaporean Neurologists suggested the TIAs could be caused by damaged or hardened Arteries. My old man had his first attack on Angina at 40 years old. I Have the resources to be to able to undertake most tests they feel are adequate. I don't sit there worrying thinking ohhhh I spent 2 Grand , I'm relieved I've not got a tumor or cancer and I've not just seen my wife and kids for the last time, If I'm going to "Spend" Money I'd rather do it taking care of myself than some stupid 20 K car or ridiculous over priced ex-council house. It seems the accumulation of money for the kids "Futures" is all what life is about , how about taking care of yourself and "Spending"" dough on that so you are around when they have their kids. I will not agree to the suggestion I am being Naïve. I suppose I could have spent the money on 2 weeks in Magaluff. If you are British as I am , I think we take free Government treatment for granted as we do with all government "Services"

No one is suggesting that you should not expend resource on securing health care.

What is being suggested is that you ensure you are informed adequately about the need and reasons for, any investigation and treatment.

If you are happy with the explanations provided and understand what you are consenting to then fine if not then seeking a second opinion would be wise

Over-investigation / treatment of medical conditions is a well researched fact which affects some health care systems more than others.

I actually have 1 GP and Three Neurologists opinions, 1 mainly private at Mount Elizabeth Hospital other one Singapore General another ,Pattaya Bangkok hospital. GP sent me for consultation the day it happened . private and not on out crappy insurance hospital which are ok if you can wait 3 months for a consultation , cost me 100 quid or 200 Sing dollar, CT scan at local Thai hospital 4000bt, back to consultant who is convinced it is not my brain with something wrong after ct scan but says MRA will confirm if I have a problem with blood flow clots forming ect. The MRA from Heart to Head showed no damage of forming of blood clots or narrowing of arteries,18000bt, Just this Hydro thing, which he said in his report "Was very slight" . My referral to Neurologist then came through after 5 weeks after the event to Singapore General. Chinese lady, She was like an angry Mum and GP/Neuro ' Who's looking after you' ? She shouted at me, and then I was on some kind of strength test against her mainly , her balance was better than mine. I trust most of these people quite a lot, one not quite so much . however I am on my own here , family in Thailand. I need these peoples support and to listen to their advice. LP is optional really I just want everything cleared up and get on with my life, I think most people would pay 25000 baht (500) quid to find out why they had a TIA and the likely-hood of another heavier attack

[This Thing of Darkness]

Had another TIA last Wednesday , was more a like full blown.Started as I reached Kranji station and made the 5 minute walk up hill to my office to get an ambulance called. Every limb was numb my face and once again could not talk, I had to go for office as no guarantee if I collapsed outside that, that someone would call an ambulance, so had to grin and bear it and make it to my office, Up hill is actually easier as the hill balances you if you have no feeling in your lower legs , Downhill is a disaster. Ambulance called, blue lights "Music" and 4 Nights in Hospital

They completed the Testing with Brain MRI, Carotid Ultrasound, Heart Ultrasound. Already had MRA's neck and Brain, CT Brain, Chest Xray, no issues with any of them. Only a bit of "Water on the Brain", which was dismissed as "Minor" before everything else was dismissed is now a possibility for cause, pressure on the brain

[chubby]

so is this your official diagnosis at the moment:

http://www.webmd.com/brain/normal-pressure-hydrocephalus

are you taking any blood thinners, eg

http://www.drugs.com/pro/clopidogrel.html

how many total "TIAs" have you had and when...

is there anything new they are suggesting your to do?

[This Thing of Darkness]

3 in 5 months

Aspirin

nope

[Sheryl]

It really does not sound like the very small degree of hydrocephalus could account for this.

It also sounds like the impairment is sensory more than motor. I continue to suspect atypical migraine or atypical seizure given the normal scans and doppler.

[This Thing of Darkness]

It really does not sound like the very small degree of hydrocephalus could account for this.

It also sounds like the impairment is sensory more than motor. I continue to suspect atypical migraine or atypical seizure given the normal scans and doppler.

Thanks , I'll put that too him tomorrow, As said if hydrocephalus was minor before I did all the other tests, scans and now its not so minor. If I went with a chance to do LP tomorrow, do you think I should ask him to look at what you suggest. I comes on Gradually a few minutes to peak, my life long mate was an epileptic and he said he could feel them coming, I would assume a brain or artery blockage , neither of which have been detected , would be far faster in reaction

The MRA report says Mild Hydrocephalus, does no indicate it as a cause, I asked him what he could do. It is all different now I have had a another event. Seeing consultant at Singapore General on Tuesday

Edited November 26, 2015 by This Thing of Darkness

[Sheryl]

An LP would be of no value in diagnosing either seizure or migraine.

EEG would be helpful re seizure.

[chubby]

the epilepsy thing they call an "aura"

by definition, no lesions are going to be noted, as the 'blockage' was 'transient' , though, they might detect narrowing with contrast i suppose.

your taking 81mg aspirin? specifically for this ? or for your heart?

i'm pretty sure if you have hydrocephalus, it is pretty rare in adults, if you do have it, it likely would be secondary to blockage from another source of the problem

Obstruction most often occurs in the aqueduct of Sylvius but sometimes at the outlets of the 4th ventricle (Luschka and Magendie foramina). The most common causes of obstructive hydrocephalus are

• Aqueductal stenosis

• Dandy-Walker malformation

• Chiari II type malformation

Aqueductal stenosis is narrowing of the outflow pathway for CSF from the 3rd ventricle to the 4th ventricle. It may be either primary, or secondary to scarring or narrowing of the aqueduct resulting from a tumor, hemorrhage, or infection. Primary aqueductal stenosis may involve true stenosis (forking of the aqueduct into smaller, poorly functioning channels) or presence of a septum in the aqueduct. Primary aqueductal stenosis may be inheritable; there are many genetic syndromes, some which are x-linked (thus male infants inherit the condition from otherwise unaffected mothers).

[This Thing of Darkness]

Had EEG ,admitted me in and had it on for 20 hours, "nothing extraordinary" again . Its a lot to do with my job the TIAs or whatever they are started, I m construction management for 27 years and the <deleted> put me into Design management dept. They have recognised lack of sleep and anxiety as contributory factor and given me low MG Xanax , Testing is over for me now no issues at all had CT, MRI and Mra Brain and neck , Ultrasound carotid arteries and heart . The Hospital an neurologist I have been referred to I will hopefully see once a month. I will return to work n light duties (office 5 days a week)

[Sheryl]

On the basis of exclusion (having ruled out all else) sounds like migraine variant. With stress likely the trigger.

Careful with the xanax, it is highly addictive.

As you live in Singapore might do well to consider a meditation course here https://www.dhamma.org/en/schedules/noncenter/sg

[This Thing of Darkness]

Thanks ,I was reading this as well Conversion Disorders , Similar Symptoms but no physical cause

http://emedicine.medscape.com/article/287464-overview#a4

[This Thing of Darkness]

On the basis of exclusion (having ruled out all else) sounds like migraine variant. With stress likely the trigger.

Careful with the xanax, it is highly addictive.

As you live in Singapore might do well to consider a meditation course here https://www.dhamma.org/en/schedules/noncenter/sg

Stress is definitely the trigger

[cumgranosalum]

Sounds as if you have been mislead about the NHS.......

Seeking medical advice

In the early stages of a TIA, it's not possible to tell whether you are having a TIA or a full stroke, so it's important to phone 999 immediately and ask for an ambulance.

Even if the symptoms disappear while you are waiting for the ambulance to arrive, an assessment in hospital should still be carried out.

A TIA is a warning that you are at risk of having a full stroke in the near future, and an assessment can help doctors to determine the best way to reduce the chances of this happening.

If you think you may have had a TIA previously, but the symptoms have since passed and you didn't seek medical advice at the time, you should make an urgent appointment with your GP so they can determine whether to refer you for a hospital assessment.

[Sheryl]

Sounds as if you have been mislead about the NHS.......

Seeking medical advice

In the early stages of a TIA, it's not possible to tell whether you are having a TIA or a full stroke, so it's important to phone 999 immediately and ask for an ambulance.

Even if the symptoms disappear while you are waiting for the ambulance to arrive, an assessment in hospital should still be carried out.

A TIA is a warning that you are at risk of having a full stroke in the near future, and an assessment can help doctors to determine the best way to reduce the chances of this happening.

If you think you may have had a TIA previously, but the symptoms have since passed and you didn't seek medical advice at the time, you should make an urgent appointment with your GP so they can determine whether to refer you for a hospital assessment.

I don't follow, what does the NHS have to do with this?

The OP has already seen not just a GP but a number of specialists and undergone a very extensive workup.

[cumgranosalum]

Sounds as if you have been mislead about the NHS.......

Seeking medical advice

In the early stages of a TIA, it's not possible to tell whether you are having a TIA or a full stroke, so it's important to phone 999 immediately and ask for an ambulance.

Even if the symptoms disappear while you are waiting for the ambulance to arrive, an assessment in hospital should still be carried out.

A TIA is a warning that you are at risk of having a full stroke in the near future, and an assessment can help doctors to determine the best way to reduce the chances of this happening.

If you think you may have had a TIA previously, but the symptoms have since passed and you didn't seek medical advice at the time, you should make an urgent appointment with your GP so they can determine whether to refer you for a hospital assessment.

I don't follow, what does the NHS have to do with this?

The OP has already seen not just a GP but a number of specialists and undergone a very extensive workup.

He was claiming a wait on NHS - the truth is this is often a precursor to a stroke so they won't delay unnecessarily.

[This Thing of Darkness]

I had my monthly appointment today at Singapore General with the "Resident " Neurologist. My plan now I have had all the "Critical tests/scans ect' Is to stay "Referred " to Singapore General. She has referred me to very senior cardiologist, both She and consultant in Thailand doubt I am having TIA/Stroke. One passage for heart ultrasound mentions' Moderately dilated left Atrium' Normal left and right ventricular systolic function. No regional wall motion abnormality. Pulmonary valve Regurgitation Mild Tricuspid valve regurgitation, Trivial No pericardial effusion, No intra cardiac shunt , no Thrombus. They are also convinced I suffering from anxiety attacks which apparently make the above worse. Three attacks in 5 months , 5 months I've been in this job. I was employed as construction manager of which I have done for nearly 30 years, but they have changed my role to design, which I hate with a passion. Also hospital have booked me with their psychiatrist . This is sort of the plan I had to get all of the Scans MRIs , MRAs and ultrasounds out of the way quickly, then grind away with the smaller issues

[This Thing of Darkness]

Moderately dilated left Atrium' is not "Moderate" at all from a conversation I had and stuff I have read. The appointment for the cardiologist went over about 3 hours then they said 2 people then the smsed me an hour later and said 5 people are now in front of me, so I buggered off and sat in casualty, my 3 TIAs if they are TIAs have all been triggered by Rage mainly, which is getting worse , Xanax are helping of course, still a bit dozy in the morning, but you can still lose it. They now want me to see hospital Trick cyclist, because I was prescribed Xanax in Thailand. Their views are the rest of the world is nothing compared to their utopia, actually everything is false and superficial. Government Hospitals are worse than ours were in the 80s. Their morals are like something out of US TV show of the fifties, patronizing and naïve at the same time