2nd patient - TIA

ohya..i stil remember my first patient name ,his name is chi chai.quite cute name right~haha

then my second patient , an old women around 80 years old.

Hypertension,high cholesterol,weak on left hand..

after CT scan result doctor say she having TIA- Transient ischaemic attack.

serious,this patient's family really trust me,cause on that time i'm the only chinese-speaker medical student there,so,evrything happen they jz come to me..

but feel so useless that i cant help her most of the time due to i dunno anything..

kind of sad that i'm only be able to bcum translator of the doctor repeat what the doctor say only n doesnt know what actually TIA is.. what i explain to her is only mam, there;s a cyst in ur mother brain.

so the maam ask me is tat stroke? serious ,my stupidity ..i dunno..haixx..

then the doct say,yes,it's a kind of stroke.then the mam teach back me wat actually stroke is..haha..but lucky learn sumthing from mistakes.. 

so here now lets reveal wat TIA really is...

TIA actually is a mini-stroke,where it's cause by temporary (oxygen shortage) no blood enter to the brain due to blockage or blood clumps in the brain.it is an early warning signs of stroke.

Signs and symptoms :

i. temporary losing vision (typically 

ii. difficulty in talking(Aphasia)

iii. weakness in one side of body(hemiparesis )

iv. numbness or tingling (paresthesia)

Diagnosis :

CT scan, MRI,ultrasound,echocardiogram of heart( if blood clot from heart)

Medication:

anti-platelet drugs: aspirin

Anti-coagulation drugs : heparin,warfarin

Treatment :

i. initial treatment-aspirin,second line (PLAVIX)clopidrogel, third line      triclopidine.

ii. if TIA recurrent after aspirin given, combination of aspirin and dipyridamole(aggrenox) is needed.

iii. if TIA affects area of carotid artery ,an ultrasound (TCD) scan may demonstrates carotid stenosis(narrowing), if stenosis more than 70%, a carotid endarterectomy(CEA) surgical is needed to remove the plague out.carotid can be replace by vesseld of legs or foot.

Prognosis :

the risk of TIA can be calculated by using ABCD²

ABCD² score

	Age	Blood Pressure	Clinical Features	Duration	Diabetes
0 points	<60 years	normal	other than those specified	less than 10 minutes	no diabetes
1 points	≥60 years	raised (blood pressure ≥140/90)	speech disturbance without weakness	10 to 59 minutes	diabetes present
2 points			unilateral (one-sided) weakness	≥60 minutes

==Interpretation The risk for stroke can be estimated from the ABCD² score as follows:

• Score 1-3 (low)
  • 2 day risk = 1.0%
  • 7 day risk = 1.2%
• Score 4-5 (moderate)
  • 2 day risk = 4.1%
  • 7 day risk = 5.9%
• Score 6–7 (high)
  • 2 day risk = 8.1%
  • 7 day risk = 11.7%