Neuro

Neurologist Response

Mr. C, a TIA stands for Transient Ischemic Attack. It is sometimes called a mini-stroke. However, it's not really a stroke at all, because in a TIA none of your brain gets permanently hurt like it does after a stroke. Unfortunately, we're still not very good at making strokes go away once they've occurred. Many people think that because we have these new clot-busting drugs, we can just fix up someone once they have a stroke. However, the clot-busting drugs don't work for everybody, so it's really important that we prevent strokes from happening in the first place. We're concerned about you because TIAs are warning signs that a stroke might happen.

Strokes often occur when a little bit of "stuff" gets stuck in an artery in your brain. Hardening of the arteries can lead to build up of cholesterol or fat on the insides of your arteries. Sometimes blood clots can also form on the inside of arteries. If a bit of this stuff breaks off and flows along with the blood until it gets stuck in a smaller artery, it may block it. Then you get symptoms, like when you had trouble talking this morning. If you are lucky, the little bit of stuff falls apart and travels on to some smaller artery where it won't cause any symptoms. That's probably what happened to you. If you're not lucky, the stuff in the artery remains stuck there and permanently blocks it. Then you get a stroke, and you have permanent symptoms because the part of your brain that the artery goes to will die. 

Our job now is to look for the place in your body where the "stuff" came from, and then try to figure out how we can prevent it from blocking up a brain artery again. We're going to do some tests on the arteries that supply your brain to look for material that is collected there. If we don't find anything there, we'll look to see if there are problems with your heart that might have caused blood clots to form there. Depending upon what we find, you might need treatment like stronger medicines than aspirin. For now I want you to keep taking an aspirin every day because we know it's good at preventing TIAs and stroke. Even though you don't need a prescription to get it, aspirin is still a strong medicine. It works to make your blood less sticky so the blood is less likely to form little clots inside your arteries.