Discussions By Condition: I cannot get a diagnosis.

Vertigo, Abnormal EKG, MRI - is it transient ischemic attach

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Anonymous
  • October 2, 2010
  • 02:57 AM

My dad told me in the morning that the night before he felt very weird and uncomfortable whenever he laid down flat. I saw that he fell asleep sitting up the night before, but thought he just fell asleep watching television. He's been pretty much bed ridden with a herniated disc for the past couple of months, so that was not unusual. In the morning, when he told me about the weird lying down, I asked him if it went away if he lay down for longer and he said he had not tried out because the feeling was so alarming. I made him lie flat and he shot up in a panic - like I said, he has a herniated disc, so I was shocked when he moved up so fast. I took him to the ER. The ER doctor said it might be vertigo, but we have to rule out signs of stroke. He laid my dad flat for about 30seconds and then inclined the bed back up. My dad said that he did not get the weird feeling immediately, but started feeling it when the doctor moved in him up and then it was overtaken by dizziness. The ER doctor did the follow with the eyes thing and sent my dad for a CT scan. That came back normal and the ER doctor did the follow the eyes thing with my dad. He said that he'd rather have an MRI done since my dad's eyes did not do a quick flicker thing that is characteristic of vertigo. Then he told me that my dad had a odd EKG reading and regardless of what the MRI says, he should follow up with a cardiologist. Well, the new ER doctor told us that the MRI came back normal and we could go home. I had done some research at the hospital and found that this may be Transient Ischemic Attack (TIA) and arterial fibrillation which is a sign of a possible stroke near future. Unfortunately, I took my father to the ER on Friday, so no doctors to call on the weekend. Also, the MRI report doesn't seem "normal" to me.

I'm torn between taking my dad back to the ER on Saturday and waiting until Monday. I have my mom on red alert for any signs of stroke, but makes me worried. Both his father and brother died from strokes. Any info is greatly appreciated. Below is what I got from his docs

ECG: normal sinus rhythm. Incomplete right bundle branch block. T wave abnormality, consider anterior ischemia. Abnormal ECG.

MRI/MRI Brain Scan W & W/out, MRI/MRA Neck W/contrast, MRI/MRA Brain w/o Contrast - Findings MRI Brain:
no intracranial mass effect is seen. There are a few foci of increased FLAIR and T2 signal in the deep white matter and periventricular region right side subtly more than left, without ennancement of these sites. No abnormal intracranial enhancement is seen. The ventricular system is symmetric. The globes are symmetric. no posterior fossa mass is seen. No intracranial mass or hemorrhage is seen. No restricted diffusion sites are seen on the diffusion/isotopic scans.

IMPRESSION: MRI BRAIN
No intracranial hemorrhage mass effect or infarct seen. Mild white matter changes probably small vessel ischemic basis.

Procedure: MRA NECK MRA HEAD
FINDINGS: There is left vertebral artery dominance. The right vertebral artery is thin and irregular throughout most of its course. Distally there is at least some filling of muscular branches along the distal aspect of the right vertebral artery. There is thin distal right vertebral artery as it contributes to the basilar artery.
The basilar artery is patent. There is no significant stenosis involving the visualized common carotid artery on either side. The internal carotid arteries are of similar caliber and patent without identifiable atheromatous changes at the carotid bifurcation on either side.
There is a fetal origin of the right posterial cerebral artery. The anterior and middle cerebral no major vessel stenosis or cutoff is seen. No aneurysm is seen at the base of skull. arteries are seen on each side.
IMPRESSION: (1) No identifiable aneurysm. (2) No carotid atheromatous changes. (3) Hypoplastic irregular right vertebral artery. Left vertebral artery dominance.

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