3 years

I have a 55 years old mother with hypertension

Doctor, I have a 55 years old mother with hypertension for 7 years on oral antihypertensives. I am grateful that she has not been having complications throughout her years of having hypertension. However, only recently during a casual dinner that she told me about a month ago, she experienced weakness on her right upper limb for a week after which she recovered without medications. She said it was heavy and sore her activities for that week was affected. I’m a nursing student and have seen cases like this before. It’s known as minor stroke, isn’t it? I have scolded her for dismissing the situation and not telling me earlier. I am worried sick since it’s already a month late since she told me and i’ve learned that the latter the treatment, the higher the chances of her having another stroke or risk of death.

Dr Ramzdhan,

4 years

Hi there! Thank you for your question. So yes based on the symptoms, you mentioned and based on the fact that it recovered itself, it looks like a Transient Ischaemic Attack (TIA). Allow me to explain a bit about TIA and how we manage it.

Transient ischemic attack (TIA) is a common neurologic problem and are brief episodes of neurological dysfunction resulting from focal cerebral ischemia not associated with permanent damage.

The risk factors of TIA includes previous TIA, hypertension, atrial fibrillation, hypercholesterolaemia, diabetes mellitus, smoking, family history, heart disease and increasing age.

The symptoms of TIA varies depending on territory of the train affected but in general the presentation is similar to stroke. Most symptoms of TIA happens suddenly and the intensity is maximum on onset. Most TIAs last 5-15mins and complete recovery can take from hours to days.

Complete revovery is usually within a few hours. The diagnosis requires clinical features AND an imaging study that confirms no brain cell death.
The clinical features are the same as stroke and the most common symptoms include painless, temporary loss of vision, one-sided facial droop, one-sided motor weakness, double vision and problems with balance.

There are symptoms that suggest it is NOT a TIA :
o Loss of consciousness
o Acute Confusion
o Seizure
o Loss of Memory
o Isolated dizziness, light-headedness or vertigo
o Gradual progression of symptoms
o Multiple recurrent symptoms
o Severe Headache
The investigation that will be done are CT brain/ MRI brain, ECG, telemetry/24 hour holter monitor, fasting glucose and total cholesterol, carotid Doppler, echocardiogram, FBC, fasting glucose/lipids and troponin.

The management includes aspirin 300mg x 10/7 then 75mg od, clopidogrel, aspirin ±dipyridamole in some cases, anticoagulation and endarterectomy (should be performed within 2 weeks of the patient’s last symptoms).

Long-term prevention includes blood pressure control, statin, smoking cessation, exercise, screening for diabetes and no driving for 30 days
So I suggest you bring your mother to the doctors, so a proper diagnosis can be made using imaging and appropriate management can be planned for her.

Please click on this link (DoctorOnCall) to talk to us privately online and discuss further about your inquiries. Thank you.

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