Transient Ischemic Attacks and Strokes Archives

Walt - please help!

Namaste, Walt

My father, age 86, was sent by his primary care physician for an MRI and a carotid Doppler ultrasound a little over 10 days ago after my father reported the following to him:

He woke up some time after midnight with the scalp on one side of his head itching, stinging, feeling as if bugs were crawling on it. He had no pain, except for something like pain behind his eyeballs, as if they were about to pop out of his head (pressure?). When he got up the next morning, he was unable to walk straight, could only stagger, as if his brain wasn't communicating with his feet, and he couldn't control his movements. He was not dizzy, had no vertigo (he has Meniere's so he knows very well what dizziness and vertigo are like). It was two weeks before he was able to walk reasonably well again and still doesn't feel totally in control. He has been on ProCardia for hypertension for several years.

His doctor may have suspected he'd had a TIA (although he didn't tell my dad that) because he had him start taking an aspirin every day.

Last week, he went to his doctor's office and obtained copies of the test reports. Here's what they say:

MRI: There are scattered areas of abnormal T1 and FLAIR signal throughout the deep white matter consistent with chronic small vessel ischemic changes. There is no evidence of acute infarction with diffusion weighted images. The ventricles are normal in size, shape and position for the patient's age. There is mild diffuse cerebral and cerebellar atrophy consistent with the patient's age. The vascular flow voids are unremarkable. No other findings.
IMPRESSION: Scattered small vessel ischemic changes in the deep white matter, no evidence of acute infarction, mild cerebral and cerebellar volume loss consistent with the patient's age.

Carotid Doppler Ultrasound: High resolution real-time imaging of the extracranial carotid artery systems with duplex imaging and color flow mapping shows only minimal atherosclerotic plaque formation along the posterolateral wall of each bifurcation. No evidence of appreciable stenosis. No evidence of ulceration, abnormal velocity or turbulence. Both internal and external carotid arteries are widely patent. The vertebral arteries are patent with antegrade flow. IMPRESSION: Normal real-time Doppler evaluation, duplex imaging and color flow mapping of the extracranial carotid artery systems and vertebral arteries. No evidence of significant disease.

To my dad's immense frustration, his doctor has not contacted him to discuss

the test results. Even if he does, the man rarely says more than two words to my dad, doesn't ask or answer questions. My dad wants to understand what happened to him and what the tests revealed so he can take any needed remedial or preventive steps. As best I can interpret the tests, he does not appear to have had a TIA, nor do they show anything that would explain his symptoms. I don't know what T1 or FLAIR signal means. I would be grateful for your opinion of what may have caused my dad's symptoms and explanation of the significance of the test findings.

Also, I would like to know whether you consider it appropriate for him to continue taking aspirin every day, and, if so, whether it would be all right for him to take ginkgo biloba supplements concurrently with the aspirin. It's my understanding that the two have similar effects in some respects. He would like to try ginkgo biloba to see if it will benefit his Meniere's Disease, but we're concerned about possibly getting a "double effect" from both ginkgo and aspirin.

We would GREATLY appreciate your advice. (Why can't more doctors be like you???)

Thank you so much,
Vicki R.

Namaste, Walt

My father, age 86, was sent by his primary care physician for an MRI and a carotid Doppler ultrasound a little

over 10 days ago after my father reported the following to him:

He woke up some time after midnight with the scalp on one side of his head itching, stinging, feeling as if bugs were crawling on it. He had no pain, except for something like pain behind his eyeballs, as if they were about to pop out of his head (pressure?). When he got up the next morning, he was unable to walk straight, could only stagger, as if his brain wasn't communicating with his feet, and he couldn't control his movements. He was not dizzy, had no vertigo (he has Meniere's so he knows very well what dizziness and vertigo are like). It was two weeks before he was able to walk reasonably well again and still doesn't feel totally in control. He has been on ProCardia for hypertension for several years.

His doctor may have suspected he'd had a TIA (although he didn't tell

my dad that) because he had him start taking an aspirin every day.

Last week, he went to his doctor's office and obtained copies of the test reports. Here's what they say:

MRI: There are scattered areas of abnormal T1 and FLAIR signal throughout the deep white matter consistent with chronic small vessel ischemic changes. There is no evidence of acute infarction with diffusion weighted images. The ventricles are normal in size, shape and position for the patient's age. There is mild diffuse cerebral and cerebellar atrophy consistent with the patient's age. The vascular flow voids are unremarkable. No other findings.
IMPRESSION: Scattered small vessel ischemic changes in the deep white matter, no evidence of acute infarction, mild cerebral and cerebellar volume loss consistent with the patient's age.

Carotid Doppler Ultrasound: High resolution real-time imaging of the extracranial carotid artery systems with duplex imaging and color flow mapping shows only minimal atherosclerotic plaque formation along the posterolateral wall of each bifurcation. No evidence of appreciable stenosis. No evidence of ulceration, abnormal velocity or turbulence. Both internal and external carotid arteries are widely patent. The vertebral arteries are patent with antegrade flow. IMPRESSION: Normal real-time Doppler evaluation, duplex imaging and color flow mapping of the extracranial carotid artery systems and vertebral arteries. No evidence of significant disease.

To my dad's immense frustration, his doctor has not contacted him to discuss

the test results. Even if he does, the man rarely says more than two

words to my dad, doesn't ask or answer questions. My dad wants to understand what happened to him and

what the tests revealed so he can take any needed remedial or preventive steps. As best I can interpret the tests, he does not appear to have had a TIA, nor do they show anything that would explain his symptoms. I don't know what T1 or FLAIR signal means. I would be grateful for your opinion of what may have caused my dad's symptoms and explanation of the significance of the test findings.

Also, I would like to know whether you consider it appropriate for him to continue taking aspirin every day, and, if so, whether it would be all right for him to take ginkgo biloba supplements concurrently with the aspirin. It's my understanding that the two have similar effects in some respects. He would like to try ginkgo biloba to see if it will benefit his Meniere's Disease, but we're concerned about possibly getting a "double effect" from both ginkgo and aspirin.

We would GREATLY appreciate your advice.

Namaste, Walt

My father, age 86, was sent by his primary care physician for an MRI and a carotid Doppler ultrasound a little

over 10 days ago after my father reported the following to him:

He woke up some time after midnight with the scalp on one side of his head itching, stinging, feeling as if bugs were crawling on it. He had no pain, except for something like pain behind his eyeballs, as if they were about to pop out of his head (pressure?). When he got up the next morning, he was unable to walk straight, could only stagger, as if his brain wasn't communicating with his feet, and he couldn't control his movements. He was not dizzy, had no vertigo (he has Meniere's so he knows very well what dizziness and vertigo are like). It was two weeks before he was able to walk reasonably well again and still doesn't feel totally in control. He has been on ProCardia for hypertension for several years.

His doctor may have suspected he'd had a TIA (although he didn't tell

my dad that) because he had him start taking an aspirin every day.

Last week, he went to his doctor's office and obtained copies of the test reports. Here's what they say:

MRI: There are scattered areas of abnormal T1 and FLAIR signal throughout the deep white matter consistent with chronic small vessel ischemic changes. There is no evidence of acute infarction with diffusion weighted images. The ventricles are normal in size, shape and position for the patient's age. There is mild diffuse cerebral and cerebellar atrophy consistent with the patient's age. The vascular flow voids are unremarkable. No other findings.
IMPRESSION: Scattered small vessel ischemic changes in the deep white matter, no evidence of acute infarction, mild cerebral and cerebellar volume loss consistent with the patient's age.

Carotid Doppler Ultrasound: High resolution real-time imaging of the extracranial carotid artery systems with duplex imaging and color flow mapping shows only minimal atherosclerotic plaque formation along the posterolateral wall of each bifurcation. No evidence of appreciable stenosis. No evidence of ulceration, abnormal velocity or turbulence. Both internal and external carotid arteries are widely patent. The vertebral arteries are patent with antegrade flow. IMPRESSION: Normal real-time Doppler evaluation, duplex imaging and color flow mapping of the extracranial carotid artery systems and vertebral arteries. No evidence of significant disease.

To my dad's immense frustration, his doctor has not contacted him to discuss

the test results. Even if he does, the man rarely says more than two

words to my dad, doesn't ask or answer questions. My dad wants to understand what happened to him and

what the tests revealed so he can take any needed remedial or preventive steps. As best I can interpret the tests, he does not appear to have had a TIA, nor do they show anything that would explain his symptoms. I don't know what T1 or FLAIR signal means. I would be grateful for your opinion of what may have caused my dad's symptoms and explanation of the significance of the test findings.

Also, I would like to know whether you consider it appropriate for him to continue taking aspirin every day, and, if so, whether it would be all right for him to take ginkgo biloba supplements concurrently with the aspirin. It's my understanding that the two have similar effects in some respects. He would like to try ginkgo biloba to see if it will benefit his Meniere's Disease, but we're concerned about possibly getting a "double effect" from both ginkgo and aspirin.

We would GREATLY appreciate your advice.

Re: helping you/consult

Re: Walt - please help! (Archive in TIAs.)

Re: helping you/consult

Re: Walt - please help! (Archive in TIAs.)

Re: Walt - please help! (Archive in TIAs.)

Re: Walt - please help! (Archive in TIAs.)

Re: Walt - please help! (Archive in TIAs.)

Re: Walt - please help! (Archive in TIAs.)