Transient Ischemic Attack (TIA) is an episode of temporary memory loss that lasts less than an hour. It may be due to compression of the spinal cord. However, it doesn’t cause spinal tissue damage. People who suffer a TIA have an eleven percent risk for stroke over the subsequent five years. In most cases, rapid transport to a hospital is recommended for an evaluation. Symptoms could include slurred speech, limping, confusion, and memory disturbance.
Initial medical exam includes blood pressure monitoring, speech function, heart rate assessment, respiratory function, and oxygen monitoring. The care provider evaluates the patient’s attentiveness, speech, and function. Periodic finger stick blood testing includes blood sugars, blood counts, and cardiac enzymes. In some instances, the patient would need a “lumbar puncture” for spinal fluid analysis.
Symptoms could include problems with walking, behavioral changes, short term memory, blurred vision, swallowing difficulty, and incomplete eye closure. Symptoms resolve over minutes. Prior medical history should include investigation of recent surgery, seizures, illicit drug use, previous TIAs, diabetes, heart disorders (i.e., patent foramen ovale) and migraines.
Medical history is crucial. This includes recent surgery, behavior changes, diabetes, previous stroke, seizures, central nervous system infection, clotting disorders, heart abnormalities, migraine, and illicit drug use. TIAs decrease consciousness. Lower extremity weakness and tingling is not uncommon.
Those who have had a TIA have risk for “vascular dementia” (bleeding in the brain, or a blocked blood vessel). An electroencephalogram might be considered to rule out seizures.
A spinal lumbar puncture is considered to rule out brain infection (meningitis). Additional workup might include a brain CT and MRI.
Those who have had a TIA within a week of hospital admittance should take aspirin 50-325 mg daily, instead of Coumadin, to prevent bleeding in the brain. Blood pressure should be maintained at 140/90.
Additional symptoms may include low blood sugar (hypoglycemia), seizures, tumor, migraine with aura, nerve root disorders, buzzing in the ears (tinnitus), and brain bleeding.
Heart evaluation includes ultrasound and testing for atrial fibrillation. This is done by “holter monitoring.”
Hospitalization is recommended for those who have symptoms more than an hour.
Blood pressure should be kept no higher than 220/120. Smoking cessation, lipid control, lowered glucose, and alcohol elimination lower it. In most cases, a weight loss and exercise program is recommended.
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