TIAs

[Protimenow]

I'm not sure WHICH subforum to post this to, so I'm putting it here because it is probably closely related to TIAs.

I get migraine auras, as do many of us here.

Over the years, I've had episodes of temporary blindness in one eye that clears up after a minute or two - the first time, it scared the crap out of me. The ophthalmologist gave it a name, couldn't find anything organically wrong, and told me that if I got it again, I should go to the E.R. It didn't, but my breathing became difficult the next day and I went to the E.R. -- I tested positive for Covid, and they ignored my respiratory issue.

I'd had this temporary (transient) optical thing a few times, and always considered it to be somehow related to the migraine auras, and wasn't particularly concerned, because they resolved quickly.

Yesterday, I looked at an article that Pellicle put the link to in one of our threads - and it described the temporary blindness as a TIA (transient ischemic attack). Perhaps as a CYA, they said to go to an E.R. when this happens.

I've had two TIAs that weren't so transient -- the first, about a decade ago, was probably a small stroke that was the result of trusting my old meter (an InRange) to be accurate (it wasn't), and believing my INR was 2.6, when it was actually a point lower. This took a few days to resolve, it lasted for a few days, and it left some deficits.

My latest was about two months ago - transient, with no residuals, when my left hand, and the left side of my mouth and tongue got numb. It's hard to find a reason for this one - INR was where it should be.

I think my point here is that 'little' things - like inability to speak clearly (jumbled words, difficulty speaking), temporary blindness, temporary weakness, may not be just short term nuisances, but actual TIAs. I've had them. I've ignored them. I didn't think these transient things were a particularly big deal because they WERE just temporary things.

Further, since my INR is in range, there's not a whole lot that can be done in the hospital - they can't give an anticoagulant because you already ARE anticoagulated, and these things are temporary anyway.

So - what I think I'm getting to here are a few things:

Have YOU had the kind of things I listed? Have you done anything about them except waiting for them to resolve?

What kind of events did you have that may have been TIAs?

Have you seen a list of symptoms of possible TIAs?

Have TIAs changed the way you live your life? (Dietary changes, for example)?

Is there anything you want to contribute to this thread?

 

[3mm]

My first responder training taught me to respond to any stroke symptoms by getting the patient to the hospital ASAP. This is so the emergency room can start using clot busting drugs immediately. I will let the ER doctor worry about the interactions of the clot busting drugs with warfarin.

I'm a reserve deputy sheriff (law enforcement officer, for our non-USA members). So I potentially will be first on scene if someone calls 911 for help. Last summer I attended refresher training with our local helicopter ambulance, since we work closely with them at medical emergencies. They specifically said that if a patient is showing any signs of stroke such as you listed above, we should have the air ambulance start toward our scene even while we and any medical personnel are deciding what is happening. The exception would be if we are within a few miles of the hospital, then ground transportation may be faster.

 

[pellicle]

Morning

I'm not sure WHICH subforum to post this to, so I'm putting it here because it is probably closely related to TIAs.

here is as good as anywhere IMO

I get migraine auras, as do many of us here.

to the best of my knowledge unrelated to a TIA

Over the years, I've had episodes of temporary blindness in one eye that clears up after a minute or two - the first time, it scared the crap out of me.

a symptom of a TIA or a stroke (not the clearing up bit unless you're lucky). This is not an area that I'm widely and deeply read in, nor specifically trained in, so most of what I say is "evidence supported conjecture" and could be mistaken in many ways. So:

https://www.mountsinai.org/health-library/diseases-conditions/transient-ischemic-attack

A TIA is different than to a stroke. After a TIA, the blockage breaks up quickly and dissolves on its own. A TIA does not cause brain tissue to die.​

(gramma error edited out by me in the above)

I'd had this temporary (transient) optical thing a few times, and always considered it to be somehow related to the migraine auras, and wasn't particularly concerned, because they resolved quickly.

I think in previous discussions we've identified that this is not thrombosis but perhaps lipid or other source

Yesterday, I looked at an article that Pellicle put the link to in one of our threads - and it described the temporary blindness as a TIA (transient ischemic attack). Perhaps as a CYA, they said to go to an E.R. when this happens.

glad to have provided something of usefulness ...

I've had two TIAs that weren't so transient -- the first, about a decade ago, was probably a small stroke that was the result of trusting my old meter (an InRange) to be accurate (it wasn't), and believing my INR was 2.6, when it was actually a point lower. This took a few days to resolve, it lasted for a few days, and it left some deficits.

suggesting it was indeed a TIA but then see the above point

My latest was about two months ago - transient, with no residuals, when my left hand, and the left side of my mouth and tongue got numb. It's hard to find a reason for this one - INR was where it should be.

sorry to hear its recurring, I think you should discuss this with a specialist or a GP at the very least and mention all the points covered in this discussion.

... I've ignored them. I didn't think these transient things were a particularly big deal because they WERE just temporary things.

I think its unwise to ignore warning signs on your "dash board"

Further, since my INR is in range, there's not a whole lot that can be done in the hospital - they can't give an anticoagulant because you already ARE anticoagulated, and these things are temporary anyway.

perhaps identification of the actual root cause could be helpful

So - what I think I'm getting to here are a few things:

Have YOU had the kind of things I listed? Have you done anything about them except waiting for them to resolve?

Yes.

What kind of events did you have that may have been TIAs?

These have emerged in the last 5 years and are best described (inaccurately) as feeling a sort of dizzy. It seems to be an eye coordination issue because if I stop and close my eyes the dizzy feeling vanishes but I can feel my eye "feels strange".

The eye movement abates after 10 minutes to an hour.

Have you seen a list of symptoms of possible TIAs?

no

Have TIAs changed the way you live your life? (Dietary changes, for example)?

no, because I found that in my case taking half a 300mg tablet every 2nd day has fixed the problem.

Is there anything you want to contribute to this thread?

Don't just take aspirin if its not doing anything, but if it does something take it.

 

[pellicle]

Hi Mark

interesting post. At the risk of segwaying (a common trait of threads here) this:

. The exception would be if we are within a few miles of the hospital, then ground transportation may be faster.

I'm also trained in first aid (although my certification has lapsed) and happen to live in clear sight of a large flat grassed area used variously by the Polo club and other horse events. This is also where the "CareFlight" guys land for medivac purposes. The town I live in is about 30min by road to the nearest district hospital but over an hour to a more major regional hospital and over 2.5 hours to the capital city (by road).

I see ambulance stuff in and out of town monthly, but choppers only once or twice in the last 3 years. IF a chopper lands here its never taking off in less than 30 min after its landed (after transfer and prep preflight).

So as you say, if a chopper lands here its someone needs a rapid flight to a medical care or can't tolerate the bumpy stuff on the roads.

Nice chatting

 

[HokieHaden]

I'm not sure WHICH subforum to post this to, so I'm putting it here because it is probably closely related to TIAs.

I get migraine auras, as do many of us here.

Over the years, I've had episodes of temporary blindness in one eye that clears up after a minute or two - the first time, it scared the crap out of me. The ophthalmologist gave it a name, couldn't find anything organically wrong, and told me that if I got it again, I should go to the E.R. It didn't, but my breathing became difficult the next day and I went to the E.R. -- I tested positive for Covid, and they ignored my respiratory issue.

I'd had this temporary (transient) optical thing a few times, and always considered it to be somehow related to the migraine auras, and wasn't particularly concerned, because they resolved quickly.

Yesterday, I looked at an article that Pellicle put the link to in one of our threads - and it described the temporary blindness as a TIA (transient ischemic attack). Perhaps as a CYA, they said to go to an E.R. when this happens.

I've had two TIAs that weren't so transient -- the first, about a decade ago, was probably a small stroke that was the result of trusting my old meter (an InRange) to be accurate (it wasn't), and believing my INR was 2.6, when it was actually a point lower. This took a few days to resolve, it lasted for a few days, and it left some deficits.

My latest was about two months ago - transient, with no residuals, when my left hand, and the left side of my mouth and tongue got numb. It's hard to find a reason for this one - INR was where it should be.

I think my point here is that 'little' things - like inability to speak clearly (jumbled words, difficulty speaking), temporary blindness, temporary weakness, may not be just short term nuisances, but actual TIAs. I've had them. I've ignored them. I didn't think these transient things were a particularly big deal because they WERE just temporary things.

Further, since my INR is in range, there's not a whole lot that can be done in the hospital - they can't give an anticoagulant because you already ARE anticoagulated, and these things are temporary anyway.

So - what I think I'm getting to here are a few things:

Have YOU had the kind of things I listed? Have you done anything about them except waiting for them to resolve?

What kind of events did you have that may have been TIAs?

Have you seen a list of symptoms of possible TIAs?

Have TIAs changed the way you live your life? (Dietary changes, for example)?

Is there anything you want to contribute to this thread?

I had planned AVR and aortic root replacement just over 3 weeks ago. My story is in the New Member Intros folder if you care to take a deeper dive.

Specific to TIAs, we are fairly confident I suffered a TIA on the table, as I awoke from surgery with extreme left side of body weakness that lasted 8-10 hours before fully resolving. In fact, I don’t even remember it. And, I had extreme double vision caused by my left eye not tracking well. The double vision, or left eye tracking, has gotten 95% better but does still persist today (3 weeks post op). I have seen an eye doctor who believes it will fully resolve within 3 months.

I pray it does as the vision issues are a complication I never even thought about before surgery.

 

[Protimenow]

In terms of some of the TIAs that I basically just ignored, one optical thing that lasted more than 10 minutes, then resolved, caused me to see an ophthalmologist - he called it something like that sounded like amarosa. The next day, I was diagnosed with Covid. The ophthalmologist didn't mention TIA - IIRC, he thought it may have been a temporary clot on the optic nerve that resolved -- rather than a TIA.

In terms of TIAs, really transient ones that only last a few minutes, then resolve, I'm thinking that these really short lasting ones might be managed in the same way they manage broken or cracked ribs -- do nothing. (They can't wrap ribs because it keeps the lungs from fully expanding and can result in pneumonia - a lot worse than a few weeks of intense pain and a few more weeks for the ribs to heal). Although the doctors can try to find the cause of the TIA, other actual 'causes' may be elusive - although lipid tests and other testing may be suggestive of results that might be associated with the TIAs.

For me, head CTs probably won't turn up anything new. Head MRIs are a bit more problematic because I have a pacemaker and the MRI can't be done unless a tech from Abbott (who made the pacemaker) is there to adjust settings before and after.

 

[pellicle]

Specific to TIAs, we are fairly confident I suffered a TIA on the table, as I awoke from surgery with extreme left side of body weakness that lasted 8-10 hours before fully resolving. In fact, I don’t even remember it. And, I had extreme double vision caused by my left eye not tracking well. The double vision, or left eye tracking, has gotten 95% better but does still persist today (3 weeks post op). I have seen an eye doctor who believes it will fully resolve within 3 months.

this sounds quite more than just a TIA, and I'm sorry you went through this. If you feel inclined I'd ask about this in post surgery to get more information how how common this is, because I don't recall reading anything like this here in the last 12 or so years I've been here (and as you may guess from my post count I'm here (even if briefly) most days. I've also had 3 OHS and never once experienced anything like that.

Has the hospital given you any details about this? Do they even know if its thrombus or calcium or even lipid in nature?

I hope it does clear up.

 

[pellicle]

MRI can't be done unless a tech from Abbott (who made the pacemaker) is there to adjust settings before and after.

interesting point. Thanks for posting that

 

[Protimenow]

Morning


here is as good as anywhere IMO


to the best of my knowledge unrelated to a TIA


a symptom of a TIA or a stroke (not the clearing up bit unless you're lucky). This is not an area that I'm widely and deeply read in, nor specifically trained in, so most of what I say is "evidence supported conjecture" and could be mistaken in many ways. So:

https://www.mountsinai.org/health-library/diseases-conditions/transient-ischemic-attack

A TIA is different than to a stroke. After a TIA, the blockage breaks up quickly and dissolves on its own. A TIA does not cause brain tissue to die.​

(gramma error edited out by me in the above)



I think in previous discussions we've identified that this is not thrombosis but perhaps lipid or other source


glad to have provided something of usefulness ...



suggesting it was indeed a TIA but then see the above point

sorry to hear its recurring, I think you should discuss this with a specialist or a GP at the very least and mention all the points covered in this discussion.


I think its unwise to ignore warning signs on your "dash board"


perhaps identification of the actual root cause could be helpful


Yes.


These have emerged in the last 5 years and are best described (inaccurately) as feeling a sort of dizzy. It seems to be an eye coordination issue because if I stop and close my eyes the dizzy feeling vanishes but I can feel my eye "feels strange".

The eye movement abates after 10 minutes to an hour.


no


no, because I found that in my case taking half a 300mg tablet every 2nd day has fixed the problem.


Don't just take aspirin if its not doing anything, but if it does something take it.

I mentioned migraine auras just to show the other ocular issues. I agree that this probably has no relation to TIAs. I've been getting them since I was 16 years old -- long before my murmur was first heard or my OHS.

 

[pellicle]

@HokieHade

I just did a bit of searching

https://newsroom.heart.org/news/ste...the-risk-of-stroke-during-after-heart-surgery

A stroke that happens during or soon after heart surgery is called a perioperative stroke. Patients undergoing heart surgery who experience perioperative stroke have a 5 to 10 times higher risk of in-hospital death, increased costs and length of hospital stay, and increased risk of cognitive decline one year after surgery. The statement cites stroke as the most feared complication of cardiac surgery – most patients would sacrifice longevity for freedom from stroke.​

​

Stroke risk for common cardiac procedures varies depending on both patient risk factors and the procedure. The risk is about 1% for a valve repair or coronary artery bypass alone; 2–3% if those procedures are combined; and 3–9% for surgeries involving the aorta, the body’s main and largest artery. Stroke risk is also higher for the 27% to 40% of patients who develop atrial fibrillation after heart surgery. Atrial fibrillation causes the heart’s smaller chambers to flutter and increases the risk of a dangerous blood clot that can dislodge, travel to the brain and cause a stroke.​

https://www.ahajournals.org/doi/10.1161/01.CIR.100.6.642

Methods and Results—Data were obtained from 2972 patients undergoing coronary artery bypass graft and/or valve surgery. [Pellicle: I didn't see aortic graft] Patients ≥65 years old and those with a history of symptomatic neurological disease underwent preoperative carotid artery ultrasound scanning. Intraoperative epiaortic ultrasound to assess for ascending aorta atherosclerosis was performed in all patients. New strokes were considered as a single end point and were categorized with respect to whether they were detected immediately after surgery (early stroke) or after an initial, uneventful neurological recovery from surgery (delayed stroke). Strokes occurred in 48 patients (1.6%); 31 (65%) were delayed strokes. By multivariate analysis, prior neurological event, aortic atherosclerosis, and duration of cardiopulmonary bypass were independently associated with early stroke, whereas predictors of delayed stroke were prior neurological event, diabetes, aortic atherosclerosis, and the combined end points of low cardiac output and atrial fibrillation. Female *** was associated with a 6.9-fold increased risk of early stroke and a 1.7-fold increased risk of delayed stroke. In-hospital mortality of patients with early (41%) and delayed (13%) strokes was higher than that of other patients (3%, P=0.0001).​

...

Conclusions—Most strokes after cardiac surgery occurred after initial uneventful recovery from surgery. Women were at higher risk to suffer early and delayed perioperative strokes. Atrial fibrillation had no impact on postoperative stroke rate unless it was accompanied by low cardiac output syndrome.​

PS:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809704/

A stroke that happens during or soon after heart surgery is called a perioperative stroke. Patients undergoing heart surgery who experience perioperative stroke have a 5 to 10 times higher risk of in-hospital death, increased costs and length of hospital stay, and increased risk of cognitive decline one year after surgery. The statement cites stroke as the most feared complication of cardiac surgery – most patients would sacrifice longevity for freedom from stroke.​

​

Stroke risk for common cardiac procedures varies depending on both patient risk factors and the procedure. The risk is about 1% for a valve repair or coronary artery bypass alone; 2–3% if those procedures are combined; and 3–9% for surgeries involving the aorta, the body’s main and largest artery. Stroke risk is also higher for the 27% to 40% of patients who develop atrial fibrillation after heart surgery. Atrial fibrillation causes the heart’s smaller chambers to flutter and increases the risk of a dangerous blood clot that can dislodge, travel to the brain and cause a stroke.​

HTH

 

[Protimenow]

this sounds quite more than just a TIA, and I'm sorry you went through this. If you feel inclined I'd ask about this in post surgery to get more information how how common this is, because I don't recall reading anything like this here in the last 12 or so years I've been here (and as you may guess from my post count I'm here (even if briefly) most days. I've also had 3 OHS and never once experienced anything like that.

Has the hospital given you any details about this? Do they even know if its thrombus or calcium or even lipid in nature?

I hope it does clear up.

It also sounds like more than a TIA to me, too.

It also raises the question of how long can 'transient' really apply? In my case, and the case of another on this site, I had numbness in my left cheek, the left side of my tongue, and parts of my left hand that resolved completely (for me) in about 2 1/2 days and resolved more quickly for the other with the same symptoms. Because it completely resolved, does this still make it transient? If, as in the case of HokieHade, it resolves in 6 months mean that it's still transient? Wouldn't 'normal' healing - internal rewiring in the brain over time - more strongly suggest that it's a stroke that is slowly resolving, rather than a transient event? Perhaps there were transient symptoms that resolved rapidly and a stroke that has taken longer to resolve (if it ever does completely).

I can see that the ocular things that I didn't even consider to be TIAs and that resolved in minutes can be considered to have been TIAs.

An event that I had more than a decade ago - brought on by an actual clot forming because my INR meter was giving me a higher value than what was accurate - and was described as a TIA or, as the doctors called it, a 'mini-stroke' actually wasn't a TIA because not everything resolved, and some damage was seen on MRI.

So - we may be at a definition issue - again, is the criterion for TIA that everything resolves, no matter how long it takes? What does it actually take for a TIA to be considered a stroke? (Evidence on MRI or CT scan that shows actual defects?)

I have a tendency to push things like this - especially verbal stuff (I make my living with words, and look at things fairly analytically) - so excuse me if I'm pushing the envelope a bit too much.

 

[vitdoc]

Over the years I have had several episodes of transient loss of partial vision in one eye that lasted a few minutes. Usually one loses either inferior or superior visual field.
Very few if any thing causes this other than a temporary closure of a branch retinal artery.
If the main trunk of the artery is blocked everything goes dark. Temporary loss of vision like this is called amaurosis fugax. “Fleeting darkness”. Several things may clog the vessel including small blood clots, pieces of cholesterol, and calcium fragments. They can originate from the heart, carotid arteries or even from placement of TAVR devices or heart surgery.
The distinction from a true stoke is the short term closure with marked recovery if the blockage doesn’t last too long.
When I had mine I wasn’t following my INR well and presumably I got the small emboli from the mechanical valve surface with a low INR.
If these episodes continue with adequate INR levels than antiplatelet agents can be added.
If the transient episodes are associated with more diffuse neurological findings the term TIA is often used.
If by chance my INR levels fall too low I sometimes pop some aspirin until the INR is better.
In my case I believe all of my episodes occurred when I was riding a bicycle. Perhaps the extra flow and rapid heart rate dislodged the embolus from the valve.
Pure speculation.
Incidently, I got hit by a moving vehicle 10 weeks ago while riding a bike while on warfarin. Four ribs and a clavicle broken some nice hematomas but avoided hitting my head. No major internal bleeding. INR mid twos.
I think if I hit my head things may have turned out a bit differently. Yes, I have started riding again.

 

[pellicle]

Good morning
a very interesting post, thanks. However if you don't mind:

The distinction from a true stoke is the short term closure with marked recovery if the blockage doesn’t last too long.

what does closure mean in this context, is it meaning the blockage (or occlusion).

If the transient episodes are associated with more diffuse neurological findings the term TIA is often used.

right, so this part is probably also important in differentiating a TIA from a stroke too?

If by chance my INR levels fall too low I sometimes pop some aspirin until the INR is better.

a good idea IMO

In my case I believe all of my episodes occurred when I was riding a bicycle.

this is interesting, because I once worked with a fellow who only had TIA's when he was exersizing. He had a tilting disc valve and we suspected (we includes his cardiologist, him, his wife and me) the cause was activating of platelets by the valve opening and closure jets.

Incidently, I got hit by a moving vehicle 10 weeks ago while riding a bike while on warfarin. Four ribs and a clavicle broken some nice hematomas but avoided hitting my head. No major internal bleeding. INR mid twos.

shlt mate, that's no good, I haven't been hit since my 20's and I'm pretty sure I don't want that now in my late 50's. I imagine that's amplified for you.

I hope you recover smoothly and are back in the saddle soon.

Best Wishes

 

[vitdoc]

Yes, closure means probably reduced or no flow for a period of time. If the clot breaks up and the flow is restored early enough the neurological damage may be reversed. In the eye we can see the embolus in the retinal circulation. We can also see the degree of closure which is not always 100%. We inject a dye - fluorescein into the vein in the arm and watch it flow through the retinal circulation. Sometimes the clot completely blocks the flow and occasionally there seems to be some but reduced flow. The hope is that the clot will break up. TPA is given for major stroke symptoms with evidence for a non hemorrhagic stroke. This will break up the clot and hopefully restore function if the blockage has not been to long. For the eye TPA has not yet come into use generally. Probably in many cases the process has been going on too long before it is recognized. But I think that TPA for some cases of retinal artery occlusion may become more main stream in the future. Sometimes the retinal vessel is blocked by a bit of cholesterol or even calcium. Efforts to clear these have been done surgically and via YAG laser that can sometimes breakup or shift the embolus. This is tricky due to bleeding.

 

[Protimenow]

Over the years I have had several episodes of transient loss of partial vision in one eye that lasted a few minutes. Usually one loses either inferior or superior visual field.
Very few if any thing causes this other than a temporary closure of a branch retinal artery.
If the main trunk of the artery is blocked everything goes dark. Temporary loss of vision like this is called amaurosis fugax. “Fleeting darkness”. Several things may clog the vessel including small blood clots, pieces of cholesterol, and calcium fragments. They can originate from the heart, carotid arteries or even from placement of TAVR devices or heart surgery.
The distinction from a true stoke is the short term closure with marked recovery if the blockage doesn’t last too long.
When I had mine I wasn’t following my INR well and presumably I got the small emboli from the mechanical valve surface with a low INR.
If these episodes continue with adequate INR levels than antiplatelet agents can be added.
If the transient episodes are associated with more diffuse neurological findings the term TIA is often used.
If by chance my INR levels fall too low I sometimes pop some aspirin until the INR is better.
In my case I believe all of my episodes occurred when I was riding a bicycle. Perhaps the extra flow and rapid heart rate dislodged the embolus from the valve.
Pure speculation.
Incidently, I got hit by a moving vehicle 10 weeks ago while riding a bike while on warfarin. Four ribs and a clavicle broken some nice hematomas but avoided hitting my head. No major internal bleeding. INR mid twos.
I think if I hit my head things may have turned out a bit differently. Yes, I have started riding again.

And I made a deal out of my two broken ribs. What happened to me was nothing compared to your injuries. I'm glad you're back on your bike.

It's been about 8 weeks for me - I found myself sleeping on the side where my ribs were broken last night - and returned to balance therapy last week.

As far as the optical issue - for me, it resolved quickly (in all but one case). I didn't think it was a TIA, but read a paper that included this as a symptom of a TIA.

Over the years, once in a while, I'd have a hard time forming coherent words - but this was ALWAYS after an ocular migraine, and I always linked the two. I haven't had this for a few years - and I'm not looking forward to getting it again.

 

[pellicle]

This is tricky due to ...

... lots of things

Glad you're doing well now.

 

[BGold]

I'm not sure WHICH subforum to post this to, so I'm putting it here because it is probably closely related to TIAs.

I get migraine auras, as do many of us here.

Over the years, I've had episodes of temporary blindness in one eye that clears up after a minute or two - the first time, it scared the crap out of me. The ophthalmologist gave it a name, couldn't find anything organically wrong, and told me that if I got it again, I should go to the E.R. It didn't, but my breathing became difficult the next day and I went to the E.R. -- I tested positive for Covid, and they ignored my respiratory issue.

I'd had this temporary (transient) optical thing a few times, and always considered it to be somehow related to the migraine auras, and wasn't particularly concerned, because they resolved quickly.

Yesterday, I looked at an article that Pellicle put the link to in one of our threads - and it described the temporary blindness as a TIA (transient ischemic attack). Perhaps as a CYA, they said to go to an E.R. when this happens.

I've had two TIAs that weren't so transient -- the first, about a decade ago, was probably a small stroke that was the result of trusting my old meter (an InRange) to be accurate (it wasn't), and believing my INR was 2.6, when it was actually a point lower. This took a few days to resolve, it lasted for a few days, and it left some deficits.

My latest was about two months ago - transient, with no residuals, when my left hand, and the left side of my mouth and tongue got numb. It's hard to find a reason for this one - INR was where it should be.

I think my point here is that 'little' things - like inability to speak clearly (jumbled words, difficulty speaking), temporary blindness, temporary weakness, may not be just short term nuisances, but actual TIAs. I've had them. I've ignored them. I didn't think these transient things were a particularly big deal because they WERE just temporary things.

Further, since my INR is in range, there's not a whole lot that can be done in the hospital - they can't give an anticoagulant because you already ARE anticoagulated, and these things are temporary anyway.

So - what I think I'm getting to here are a few things:

Have YOU had the kind of things I listed? Have you done anything about them except waiting for them to resolve?

What kind of events did you have that may have been TIAs?

Have you seen a list of symptoms of possible TIAs?

Have TIAs changed the way you live your life? (Dietary changes, for example)?

Is there anything you want to contribute to this thread?

I had a similar experience, which is how they found my defective aortic valve. I was sitting at my desk when it was like a roller shade coming down over my both my eyes. I never lost concousnus and was aware of what was happening and trying to re focus and come out of it. I definitely thought it was a TIA but after many tests I was told it was a Complex Partial Seizure.

 

[vitdoc]

Not sure what a Complex Partial Seizure is or how it presents. Also not sure how they made the diagnosis. If one has a TIA from a wayward blood clot there will be no evidence other than having a heart valve in place when tested later. To have bilateral complete loss of vision however could only be explained by bilateral simultaneous emboli to both eyes or to the right and left occipital lobes of the brain. Generally emboli affect one eye at a time. If a branch artery is blocked then partial vision is lost if the central artery is blocked than the entire field is lost. MIgraine will cause temporary bilateral simultaneous scotomas (blocked areas in the visual field) which are transient usually lasting 15-20 minutes and generally in the center of vision. This may or may not be associated with a head ache. Usually preceded by a scintillating scotoma which usually is a fluctuating semi circular shimmering effect seen usually to one side or the other in both eyes. As a retinal surgeon I get to see significant numbers of patients with these problems. I have also seen them myself. If the patient is sharp and gives a good description the diagnosis usually is easy.

 

[Survived03]

MIgraine will cause temporary bilateral simultaneous scotomas (blocked areas in the visual field) which are transient usually lasting 15-20 minutes and generally in the center of vision. This may or may not be associated with a head ache. Usually preceded by a scintillating scotoma which usually is a fluctuating semi circular shimmering effect seen usually to one side or the other in both eyes. As a retinal surgeon I get to see significant numbers of patients with these problems. I have also seen them myself. If the patient is sharp and gives a good description the diagnosis usually is easy.

This is the exact description of what I have had in the past. All the way down to the 15-20 minute timeframe. I used to describe the scintillating scotoma as a jagged bright light that starts small and eventually takes over the entire field of vision. Scared me the first time and I was pretty certain it was due to head trauma because of a blow to the head playing American football (actually happened twice in four years of playing). I never had it again until after my first surgery for aortic aneurysm repair. I would have them 4-5 times a year. It has been a while since I have had an ocular migraine and none since my last surgery in May. Thanks for the input.

Oh yeah, ironically my daughters have ocular migraines. No prior blow to the head though, and no prior thoracic surgery.