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Suggest Treatment For TIA Symptoms, Dizziness, Headaches And Fainting Spell

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Posted on Wed, 6 Jan 2016
Question: Hello Doctors,

Background:
I am posting on behalf of my friend whom has just had what seems to be 2 mini-stroke/TIA episodes in a span of 3 weeks. She is a 24 year old XXXXXXX female, maybe about 5 ft 10 or 11, 93kg, residing in East XXXXXXX She doesn't have a family history of strokes, has never been known to have high blood pressure or any other serious health conditions.

Lifestyle:
She is pretty active on her feet during many days, goes to the gym on and off (maybe 1 month going actively, then not going for a month sort of thing). She works full time helping her boyfriend on his start-up business, which can be quite stressful because it's just the two of them doing a lot of the work together, which many times can lead to them even arguing with each other at times. She used to smoke but very rarely, maybe 1 cigarette a day but has stopped some time ago.

Episodes:
For the first ministroke, she was in the middle of a conversation with me and I saw first hand the symptoms she encountered. Her eyes became unfocused, she stopped being able to talk properly, she wasn't able to really walk properly on her own, and her general presence wasn't sharp. Not sure if it's worth mentioning or relevant but she had a likely stressful conversation earlier that day where she was upset at her boyfriend and wanted to tell him it's over, but by the time of the TIA occuring she was perfectly calm and they had even already made up.

To make matters worse though, we are living in XXXXXXX whereby medical treatment isn't all that good at times, so when she was rusehd to the emergency room the doctors there didn't really do anything or act urgently. They first had her just lay down for 20 minutes somewhere before the doctor even came and checked on anything (if she was having a heart attack or something more urgent she probably could have died). Then when the doctor did finally come they didn't detect anything off in her full blood picture, urine, or blood pressure, so they thought she was fine.

At the time we didn't know that it was a ministroke and since she was fine in the morning we thought perhaps she just fainted. In the subsequent 2 weeks after this event she continued having headaches and dizziness spells on almost a daily basis. One day they were bad enough for us to go back to the hospital, where the doctors there again found nothing and recommended perhaps getting a CT scan done to be safe. When getting the CT scan done the radiologist there basically told her everything looked fine so she didn't follow up again with the original doctor, which likely was a mistake.

Fast forward another week, and her and her boyfriend have another fight and she packed up all of her things and left to go to her parents house. She was quite upset and distraught emotionally. The next day after reaching her parents house she was out somewhere just clearing her head and likely crying, when she ended up passing out and some people found her unconcious and brought her back home. When she was taken to the doctor they did another cat scan on her and a doctor told her she had a blood clot in the brain cutting off blood and oxygen, so they gave her oxygen, held her in ICU for some time, gave her an Anti-coagulant called Danaparoid. After she was fine they released her again but she's still been feeling some pain in the head and also had a fever the previous night.

Looking for help and advice. If it's helpful, I can post copies of her CT scans online as well or have any other tests done and posted.
doctor
Answered by Dr. Neeraj Kumar (28 minutes later)
Brief Answer:
Upload reports and CT images

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
I really want the CT images to get to a diagnosis.
With history details possibility of TIA and followed by stroke is one. The cause in Young may be cardiac illness or other vasculitis.
the other possibility may be seizures if the CT is normal.
Since she is improving and on medications she should be continued on same.
Mild headache may be due to stroke or sometimes migraine. Continuous fever may require CSF examination and other blood tests.
You should upload all possible investigations, CT and prescription or hospital discharge.
Hope you found the answer helpful.
Do get back with reports.
Regards
Dr N Kumar
neurologist


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Treatment For TIA Symptoms, Dizziness, Headaches And Fainting Spell

Brief Answer: Upload reports and CT images Detailed Answer: Hello XXXX, I have gone through your question and understand your concerns. I really want the CT images to get to a diagnosis. With history details possibility of TIA and followed by stroke is one. The cause in Young may be cardiac illness or other vasculitis. the other possibility may be seizures if the CT is normal. Since she is improving and on medications she should be continued on same. Mild headache may be due to stroke or sometimes migraine. Continuous fever may require CSF examination and other blood tests. You should upload all possible investigations, CT and prescription or hospital discharge. Hope you found the answer helpful. Do get back with reports. Regards Dr N Kumar neurologist