Background:
last sunday(9/17), my father suddenly felt
a numbness on the right side of his body -
his mouth felt a kind of "pull", and
though he did not lose mobility, he found
it difficult to sign. My mother
immediately gave him an aspirin and took
him to a doctor, who diagonized it as tia.
However, the symptoms did not completely
disappear in 24hrs (which I believe
happens with a tia).
It is now almost 10 days since. The
'pull' in his mouth is almost gone, but he
still has difficulty signing - cant sign
more than twice continuously. He was able
to drive, two days after, though he avoids
it as far as possible.
He met a neurosurgeon the next day who
advised him to undergo a suite of tests.
Here are some of the results.
Test results:
ecg: aortic valve sclerotic
homocysteine: 65 (recommended <13)
ct scan: focal low attenuation in the left
thalamus. Also shows a small dot in his
brain, which the doctor refered to as
'scar'. This, according to the doctor, is
in a place that controls motory actions,
and so the difficulty signing.
Mri: my father felt an excruciating pain
in his neck when he was strapped, and also
felt claustrophobic, so refused to take an
mri.
Doppler test: nothing unusual
lifestyle & history
my father does not smoke or drink and is a
vegetarian. He is 58 and has had high
blood pressure for the last 20 years or
so,controlled by medicaiton. Diet is
fairly balanced. He smoked for about 5-6
yrs but stopped about 30 yrs back. Works
in a desk job, and doesn't exercise much.
He drinks about 5-8 cups (150ml each) of
coffee a day. He had a similar numbness
on the right side about 10 yrs back, but
tests then did not show anything.
Doctor's diagnosis:
according to the neuro-surgeon, the high
level of homocysteine was the cause of a
very minor stroke. He has prescribed
vitamin b and folic acid tablets, and
plagril (a pill containing aspirin) for
life.
My questions:
is the diagnonsis conclusive enough? From
what I read on the net, it is not clear
whether high levels of homocysteine is a
cause or a symptom or a fall out of a
stroke!
What is the risk of another stroke? The
doctor says it won't happen since he's now
on aspirin for life.
He has frequent ulcers in his mouth,
especially when he eats out. Is it ok for
him to be on aspirin?
What is the risk of any heart/other
ailment, given this information or
background?
He has now started walking 30 min a day
and is trying to cut down on coffee. Is
this good/sufficient?
Are there any other tests he should
undergo, which might reveal more?
Is it ok for him to start driving so
soon?
Appreciate your advise!
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JUNGLE JUICE
Experienced User , Rather EHEALTHy
Joined: 17 Sep 2006 Posts: 82 Location: Barbados
Blimey Posted: 09-27-06 09:19am
To deep 4 me sorry xgood luck though.
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jkrishna
New User, Becoming EHEALTHy
Joined: 27 Sep 2006 Posts: 2 Location: Troy
Posted: 09-27-06 12:28pm
Thanks for replying anyways!
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drdgb
New User, Becoming EHEALTHy
Joined: 02 Jan 2007 Posts: 11 Location: Ireland
Posted: 01-02-07 19:51pm
Hi,
an event that shows up on ct is unlikely
to be tia so he did have a stroke. A
stroke in the left thalamus would cause
the symptoms you describe. I think the
diagnosis is fairly clearcut here. An mri
with diffusion weighting would have proven
that there was a brand new stroke there.
Homocysteine is becoming more recognised
as a cause of "vascular disease" (stroke
and heart disease) but it is not as
important as the other causes (blood
pressure, high cholesterol low hdl, high
ldl, diabetes, smkking). Your father
needs all of there monitered and treated.
He must stay off cigarettes and stay on
the aspirin.
The aspirin will not afffect mouth ulcers
but can cause stomach irritation/ulcers
and there is a tiny risk of stomach
bleeding. Watch out for stomach pain or
heartburn - he may need a
stomach-protecting drug.
That level of exercise is fine, he can
probably drive, coffee is probably not
going to affect his risk.
He has a marginally higher risk of another
stroke and heart disease having had this
event. The risk is minimised by treating
all the risk factors I mentioned.
I assume he had an echocardiogram if you
say he has aortic sclerosis. Did he have
a holter also?
