Transient Ischemic Attack, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Transient ischemic attack
Today a 60 year old man was brought in by his wife to consult me because he suddenly felt tiredness and weakness of one side of his body (right side) 1 week ago after shifting some heavy furniture.
The wife said that he was confused and went to the passenger seat instead of the driver’s seat. She had to drive him back home instead.
Once they reached home, he went to his bed and slept for 1 and a half days.
She was worried and took his blood pressure with her electronic BP set and found it to be 160/100.
She was worried and brought him to see me as soon as she was able to persuade him to do so.
On examination he was conscious and rational.
His eye reflexes were normal.
There was no neurological deficit. Babinski reflexes were normal.
His blood pressure was 170/100 which was definitely high.
Heart and lung examination were normal.
There was no evidence of any abnormal hear rhythm.
His urine and bowel movements were normal.
There was no evidence of bruit in the neck due to blockage of any blood flow.
Because of his history of one sided weakness and high blood pressure, my first diagnosis of a transient ischemic attack.
The best diagnosis is a MRI of the brain but this normally takes time.
The alternative was a non-contrast computerized tomography of the brain that will show: 1. A new area of ischemia or infarction
2. Old areas of ischemia
3. Intracranial mass, such as tumor
4. Intracranial bleeding, such as sub-dural hematoma or intra-cerebral hemorrhage
He was however stubborn about not going to hospital to take a CT Scan or blood tests in spite of his wife’s or my persuasions.
I wrote him a letter to go to the hospital for a CT scan and neurological examination in case his family could change his mind.
In the meantime I started him on anti platelet medicines such as aspirin (which he was not allergic to) and amlodipine (which is a fast calcium channel blocker for lowering his blood pressure.)
I am hopeful that he will be able to go to hospital for a checkup of his neurological and cardiovascular systems.
A few years ago my wife’s uncle was walking in the hospital to visit his wife after her knee operation when a passing nurse noticed that he was walking to one side. She got him admitted and he was diagnosed as a transient ischemic attack which later became a full blown stroke in spite of treatment.
What is a Transient Ischemic Attack?
A transient ischemic attack (TIA) is a medical disorder that occurs when blood flow to a part of the brain stops for a brief time.
Most TIAs last less than five minutes; the average is about a minute.
When a TIA is over, it usually causes no permanent injury to the brain
A person will have stroke-like symptoms for up to 24 hours.
In most cases, the symptoms last for 1 to 2 hours.
TIA symptoms occur rapidly and last a relatively short time.
A TIA is felt to be an indicator that a classic stroke may occur in the future if something is not done to prevent it.
What are the causes of Transient Ischemic Attack?
Causes
A TIA is different than a stroke.
After a TIA, the blockage breaks up quickly and disappears.
A TIA does not produce brain tissue death.
The loss of blood flow to an area of the brain can be caused by:
1. A blood clot in an artery of the brain
2. A blood clot that travels to the brain from somewhere else in the body (for example, from the heart)
3. An injury to blood vessels
4. Narrowing of a blood vessel in the brain or leading to the brain
High blood pressure is the main danger for TIAs and stroke.
The other major risk factors are:
1. Atrial fibrillation
2. Diabetes
3. Family history of stroke
4. High cholesterol
5. Increasing age, especially after age 55
6. Race (African Americans are more likely to die of stroke)
7.
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Transient Ischemic Attack, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Transient Ischemic
Attack,
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2015 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes TIA, Diagnosis, Treatment and Related Conditions or in vernacular terms
(What You need to treat TIA)
This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Conditions
into a new Wordpress Blog A Family Doctor’s Tale
on http://ken-med.com.
From which many free articles from the blog was taken and put together into 650 amazon kindle books and some into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Transient ischemic attack
Today a 60 year old man was brought in by his wife to consult me because he suddenly felt tiredness and weakness of one side of his body (right side) 1 week ago after shifting some heavy furniture.
The wife said that he was confused and went to the passenger seat instead of the driver’s seat. She had to drive him back home instead.
Once they reached home, he went to his bed and slept for 1 and a half days.
She was worried and took his blood pressure with her electronic BP set and found it to be 160/100.
She was worried and brought him to see me as soon as she was able to persuade him to do so.
On examination he was conscious and rational.
His eye reflexes were normal.
There was no neurological deficit. Babinski reflexes were normal.
His blood pressure was 170/100 which was definitely high.
Heart and lung examination were normal.
There was no evidence of any abnormal hear rhythm.
His urine and bowel movements were normal.
There was no evidence of bruit in the neck due to blockage of any blood flow.
Because of his history of one sided weakness and high blood pressure, my first diagnosis of a transient ischemic attack.
The best diagnosis is a MRI of the brain but this normally takes time.
The alternative was a non-contrast computerized tomography of the brain that will show: 1. A new area of ischemia or infarction
2. Old areas of ischemia
3. Intracranial mass, such as tumor
4. Intracranial bleeding, such as sub-dural hematoma or intra-cerebral hemorrhage
He was however stubborn about not going to hospital to take a CT Scan or blood tests in spite of his wife’s or my persuasions.
I wrote him a letter to go to the hospital for a CT scan and neurological examination in case his family could change his mind.
In the meantime I started him on anti platelet medicines such as aspirin (which he was not allergic to) and amlodipine (which is a fast calcium channel blocker for lowering his blood pressure.)
I am hopeful that he will be able to go to hospital for a checkup of his neurological and cardiovascular systems.
A few years ago my wife’s uncle