Possible new TIA?

Hi All,

I am a 57 year old male, rarely suffering from any head problems, even headaches are rare! Back in March 2019 I experienced a new event. In the morning, I was walking in town, when, suddenly, I experienced a 1-2 second interval of dizziness, which went away. Later on in the evening, a sudden surge of dizziness hit me. I could barely keep upright, and went outside to find my wife, I was all over the place, plus my speech was slurred, this lasted about jalf an hour. We phoned 111, and was advised to attend MIU, which we did. After a thorough examination, it was assumed that I had a minor TIA. I attended the stroke clinic and had a scan, which was clear. In the absence of any real proof, I was diagnosed with having had a TIA, really only by process of elimination. I was put on blood thinners, and extra medication to bring my BP a little lower. I had an ECG, which was also clear.

Nothing more happened until last Friday, when I started to feel dizzy, all of a sudden. Again, I felt a loss of balance, and then started to feel a little queezie. I felt hot and cold at the same time, and my skin became clammy. My wife said that I looked pale, but my speech was ok. After about 30-40 mins, I made a complete recovery, not even excessive tiredness, it was as if nothing had happened. Before anyone says anything, I am reporting this to my GP. Has anyone else had similar experiences? Any differential diagnosis? Not sure if it is something I should be concerned about.

Just want to reach out to see if others have had similar experiences, and what different conclusions they have come to.

Many thanks

Spencer

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Hello @Spencer, not being a medical expert, I can only advise on experience. I had six such “turns” misdiagnosed by a GP as BPPV before I had a major cerebellar stroke. Your symptoms sound “cerebellish”, dizziness, nausea. A cerebellar stroke or TIA won’t show up on a CT scan, they’ll need to do an MRI to confirm. Too much bone matter in that area for the CT scan to scan through. Okay, so having said that, they’ve given you anti-platelet medication for what reason I wonder? If you had a small haemorrhage near the cerebellar, the anti-platelet medication would be a bad idea as this could increase the chance of another TIA. Having said that, if ischaemic, anti-platelet medication is the best route but it is not foolproof.

Okay, worst scenario out of the way. It is possible you are having post-TIA symptom which will feel like a milder version of the first one. All my symptoms now mimic the TIA and stroke symptoms I had but are not as acute. This causes anxiety which causes hot flushes and clamminess. It’s the body’s natural way of expressing fear even if you consciously don’t feel it. Like the hairs that stand up on the back of the neck. It’s automatic.

I would indeed contact your GP, also I would arrange for an MRI. At the end of the day, if it shows up nothing, at least you walk away with peace of mind, and can then get on with managing any symptoms you may have as a result of the TIA. Generally, TIAs are warnings of a major stroke, and should not be ignored. Cardio and blood pressure are merely the tip of the ice-berg when it comes to stroke triggers and causes. When misdiagnosed for the second time, my GP checked my heart and blood pressure, no issue there. I don’t want to cause worry but if I can prevent someone from experiencing what I have experienced, I need to do that.

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Hi Spencer welcome to the forum. Sorry you experienced some kind of stroke. You don’t say which scan you had? My experience CT scans only show up particular strokes. MRI or cat scans are better for deeper strokes in the cerebellar area such as cerebellar lacuna infarct which I had in March 2021. August 2021 I also experienced a very dizzy head even when I closed my eyes my eyes were still flashing past with my eyelids closed. I was very nauseous and couldn’t walk straight. It lasted about 3 hours I was very scared.

My hospital in Cumbria were rubbish with my first diagnosis and sent me home after a CT scan showing nothing. I had to go back to the hospital 10 days later for the mri scan 26th March (as it was out of order) which showed I had a stroke. Though they then made another mistake and never got round to telling me until 9th April. Stroke happened 17th March. I had no medication to protect me.

When this happened again to me in august but the headache was not as painful as March they dismissed me as vertigo ( which I dispute and I’ve never had in my lifetime just turned 60 last year). I would encourage you to insist at your doctors for an MRI scan if you did not have one at the beginning.

We are all unique and experience different strokes but we are survivors and live to tell the tale on this very welcoming forum.

At the beginning I had no life line or support until I found out about stroke.org who have been amazing and all the people sharing their stories is very reassuring.

I wish you look and speedy recovery. :blush:

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Hi Rups,

Thank you so much for your useful and relevant reply. I see that you ended up having a more significant event, and I hope that you made a full recovery.

I must admit, I struggled with the logic of being given blood thinners, when the first event was thought to be caused by a bleed.

It is also fascinating to read your comments about the nausea and clamminess - I described this to the surgery as “not the sort of nausea that makes you sick, more of the nausea like when you are acutely afraid or suddenly realised something bad could happen”, I said this subjunctively as I wasn’t really aware of being afraid, so , subconscious, I guess.

Ok, I will ask for an MRI, and I will question the medication. Are you ok if I share your post with whomever is allocated to deal with me (I suspect that my GP might just refer me to the stroke clinic)?

Thanks again, and stay safe & well

Hi Loshy,

Thank you so much for your useful and relevant reply.

I think that it was a CT scan that I had, being in the medical profession myself, I am kicking myself for not paying more attention to what was being done, it was a few days, literally about 2, days after first lockdown, and everything just seemed a bit overwhelming.

I did not at any time get a headache.

I will certainly ask that I get an MRI scan.

Thanks again, and stay safe & well

Spencer

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Hi Spencer and yes that’s a good idea, I think the “professionals” should have requested an MRI for you, you will have experienced shock too and, should not have had to think what you would have needed even as a professional yourself. Good luck and be kind to yourself too. Some weeks seem fine then bam I’m knocked for six with fatigue and a hot type of trickle in my left side of neck and right foot! It really frustrates me. I’ve had a good week and today I’m having a very lazy day!! Keep going and good luck :blush:

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Hello @Spencer, yes, certainly use whatever info from me as you like. It is essential to go into these situations with as much information at hand as possible to rule out as much as possible, and to avoid “symptom satisfaction”. I’m not saying you had a cerebellar TIA, but dizziness and being unable to stand are two symptoms. Headache is not usually associated with it unless it is a haemorrhage. Unfortunately, it is a widely misdiagnosed type of stroke and I know quite a few people who had been misdiagnosed with BPPV. So, I am on high alert, whenever someone express these symptoms. The sad matter is that many people present similar symptoms, and the health care system just can’t afford to give everyone an MRI. Chances are it may be nothing, but erring on the side of caution is also a way to manage anxiety. Best of luck with it.

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Hi Loshy,

Thanks again for the reply. 10 hour shifts for me :frowning_face: Take care

hi Rups, thank you so much, will let you know.

Ten hour shifts as in work? I do not understand your sentence!

A question @Rups about TIAs being misdiagnosed as BPPV. Is it a case of doctors not being aware of the onset of a stroke and doing MRI scans right away, or is there something else I’m not getting.

Like many survivors on this forum I also a lot of dizzy spells. I can’t even count the number of times they happened from May to August 2020. The doctors gave me some meds and I tried to get on with my life and was even driving to work

The dizzy spells were then replaced with 3 episodes of sudden loss of vision. The stroke happened after the 3rd episode in September 2020.

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Hi Loshy,

Yes, 10 hour shifts at work - just in response to your comment about having a lazy day.

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@Spencer :yawning_face::flushed::joy_cat::joy_cat::joy_cat:I see no rest for the wicked.

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Hello @joy.alliy, I talked about this with my consultant today, funnily enough. If it is a cerebellar stroke, the symptoms mimic BPPV but there are other ways to determine if it is something other than vertigo, like the patients gait and something else, but I forget. My consultant said that he sends such patients with symptoms straight for an MRI which elder medical practitioners would think a no-no. This I imagine comes down to the expense of issuing an MRI. General GPs most likely don’t have a clue, they are trained to deal with a broad variety of general symptoms but anything beyond that requires specialised attention.

I had an MRI that showed up six patches of damage (TIAs) and a larger patch which was the major stroke itself. In my case, being that the stroke type was cerebellar and only a 2-3% make-up of all strokes, most doctors are not on the look out for it, and default to other conditions.

MRIs are expensive, and if they can avoid giving one, a medical professional may do so under advice from the health board. Australia has a much better system where MRIs are free out of hours, and payed for in peak times. So, if you are prepared to pop into hospital at 3 am, you can get your MRI when you want it but not at an ideal hour. However, where health is concerned, the hour is insubstantial. I could have been in a much better place had the GP not misdiagnose me, and had the hospital arrange an MRI on the spot. I still would have been in the window of receiving a clot-busting medication (although not foolproof) despite waiting 2.5 hours for the paramedics to arrive and take me to a hospital forty minutes away.

I can understand why some stroke survivors use the term stroke warriors because essentially it’s not just the wound but the context of the battle to survive that makes sense of it all.

Hi guys. This is all really useful. Like Spencer I’m new here and I had an episode (vomiting, dizziness, pins and needles and violent shaking) which the doctors think was most likely a TIA. I’m waiting for an MRI. Very interesting to know that my residual symptoms (mild nausea, slight dizziness and fatigue) are all ‘normal’. I though they were pointing to something different but they seem like classic post-stroke symptoms. Anyway - I wondered whether to refuse the MRI? Surely it will be too late (at least a month after) to show anything useful? Thanks again, this is all really helpful.

@paddy welcome paddy though I’m sorry to hear about your TIA. I cannot understand why they have left you so long for MRI. I would insist on having it. Your symptoms are classic I think quite a few of us can relate to your symptoms. I know I can. You should be on medication too. If not see your Gp or a neurologist. Please don’t ignore it. It’s best to be safe. Wishing you all the best good luck Loraine :blush:

Hi @paddy welcome, though sorry to hear you’ve had a TIA.

If I were you I’d go for the MRI, as it may still show something. TIAs can be a warning sign and they need to be taken seriously.

As Lorraine @Loshy mentions hopefully you’ve been given medication, if not you need to investigate why not.

Best wishes

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Shwmae Paddy, as far as I know, these are classic cerebellar stroke symptoms. I guess the reasoning behind an MRI might be to determine whether you have had a TIA or stroke. But also useful to rule out anything else, I guess.

Thanks Loshy. They put me on aspirin every day and I’m off to get a 24-hour heart monitor fixed today so I’ve not been completely ignored! Thanks for the confirmation re symptoms.

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Thanks Mahoney. I’m on a daily dose of aspirin (should have mentioned that). Thanks for the advice re the MRI.

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