Hi, I am posting on behalf of my father. He had a TIA in 2017 and was prescribed Clopidogrel. Initially, the drug worked wonders for him: before clopidogrel, he was getting black holes in his vision and was almost constantly dizzy.
Unfortunately, from 2018 onwards he started to decline with more stroke, with a big step change in March 2022, but he was not prescribed an anticoagulant (he was not even put on aspirin). I am trying to find out if not prescribing anticoagulant is normal? When I questioned the doctors as to why he was not prescribed an anticoagulant, I did not get an answer, so any insight or experience on the matter would be much appreciated. Is it really only people with Atrial Fibrillation that get prescribed anticoagulant?
In 2018, my dad had an MRI which showed signs of further stroke - no medication change. In Jan 2022, he had another MRI which showed more signs of stroke. This combined with a step change in March 2022 led to a TIA referral being made. Unfortunately, he had a big stroke mid April that led to a hospital admission. Even after the big stroke, his medication was not changed - he was still only prescribed Clopidogrel (same dosage). He was discharged from hospital after the first week even though he declined whilst in there. Due to his decline I opted to wait for a discharge to assess bed as I thought his strokes might not be over. He was discharged to a care facility where he continued to decline - I told the staff I thought he was having mini strokes - they told the doctor who visited the facility. His medication was not changed - still only prescribed Clopidogrel - not even sent for an MRI (but that’s an aside).
Long story short he was eventually readmitted to an acute stroke ward where they gave him an MRI and said that yes, they suspected he had been having mini strokes since his original discharge from them. Unfortunately, he ended up with Basilar Artery Thrombosis and then Basilar Artery Occlusion.
My question is given my dad’s history of stroke, age (75) , diabetes, heart disease , hypertension, high cholesterol etc. was he not prescribed a medication like Apixaban, after his big stroke in April? And, when he continued to decline, why was his medication not reviewed ?
He did not have haemorrhagic stroke.
Any insight into whether the above is normal medical procedure would be much appreciated. He did not have Atrial fibrillation, but given his history and conditions I’d have thought he’d qualify for anticoagulant?