Managing Menopausal Numbness and Transient Neurological Dysfunction
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Transient Ischemic Attack
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Managing Menopausal Numbness and Transient Neurological Dysfunction
- 2. Name Presented Case Mrs X Endometrial Carcinoma + 2ndary lung cancer Mrs S Asthma Mrs Z Hypertension + Diabetes Mr X Asperger’s Syndrome Mrs PP Chronic hypertension Bella ?
- 3. 51 YEAR OLD MENOPAUSAL WAITRESS Bella
- 5. SOCIAL HISTORY Since the age of 15 Stopped about 10 years ago, at age 40 Self explanatory
- 6. HYPERTENSION
- 8. Physical Examination Vital Signs + general observation Motor Reflexes Cerebellar Sensation Tone
- 9. Impression Exclude not Transient Ischemic Attack
- 10. Investigations ECG Doppler Test on the Carotid Artery
- 12. Definition
- 13. TELLING SIGN OF STROKE!!! Transient Neurological dysfunction caused by focal brain/retinal ischemia without acute infarction Lasting typically <60 minutes Followed by function recovery in 24 hours
- 14. Sight Change in alertness Trouble in speaking Personality, mood, Difficulty swallowing or emotional changes Muscle weakness Confusion Numbness Lack of control Difficulty writing over the bladder or reading or bowels
- 15. RISK FACTORS
- 16. Risk Factor Non- Modifiable Modifiable
- 17. Risk Factor Family History Non- Modifiable Age Gender Race Sickle Cell Disease
- 18. Risk Factor Modifiable
- 19. Plaque Formation
- 24. Investigations
- 25. General
- 26. Specific
- 27. Treatment
- 29. Treat underlying diseases Treat underlying Hypertension/cholesterol/diabetes/anaemia diseases
- 32. Clot Busters -tPA/Urokinase Angioplasty -Stenting Surgery -Bypass/Endarterectomy *Aspirin Plavix
- 34. PREVENTION
Notas do Editor
- Not on OCP
- On 20th Feb 2012, she was at home. She took leave from work that day because last night was very stressful for her. She felt headache, as sat on the sofa, suddenly, everything went blurry. The right side of her body — her arm, face and leg — went numb. She just sat very still. She was confused and scared because she was alone and all her kids were at school. She didn’t know what happened to her and she didn’t know when the numbness will stop. After two hours, symptoms went away almost as quickly as they came. She thought it was caused by headache. And she went off to pick up her kids at school and waited till the next day. On 21st she went to MediAssist4U and seek for health professional’s advice.
- General condition….alert. Pulse rate 120/70. temp 37.3 resp rate 14-18 pulse normal rhythm 70 beatsVital signs: bp, breathing rate, heartbeat rate, temperature + pain. Reflex- knee jerkMotor – push pullCerebellar – walkSensation – cotton bud, temp, firm, Tone – resist pressure
- Risk factors you can take steps to control You can control or treat a number of risk factors, including:High blood pressure. Risk of stroke begins to increase at blood pressure readings higher than 115/75 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.Cardiovascular disease. This includes heart failure, a heart defect, a heart infection or an abnormal heart rhythm.Carotid artery disease. The blood vessels in your neck that lead to your brain become clogged.Peripheral artery disease (PAD). The blood vessels that carry blood to your arms and legs become clogged.Cigarette smoking. Smoking increases your risk of blood clots, raises your blood pressure and contributes to the development of cholesterol-containing fatty deposits in your arteries (atherosclerosis).Physical inactivity. Engaging in 30 minutes of moderate intensity exercise most days helps reduce risk.Diabetes. Diabetes increases the severity of atherosclerosis — narrowing of the arteries due to accumulation of fatty deposits — and the speed with which it develops.Poor nutrition. Eating too much fat and salt, in particular, increases your risk of TIA and stroke.High cholesterol. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaques in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a statin or another type of cholesterol-lowering medication.High levels of homocysteine. Elevated levels of this amino acid in your blood can cause your arteries to thicken and scar, which makes them more susceptible to clots.Excess weight. A body mass index of 25 or higher and a waist circumference greater than 35 inches in women or 40 inches in men increase risk.Heavy drinking. If you drink alcohol, limit yourself to no more than two drinks daily if you're a man and one drink daily if you're a woman.Use of illicit drugs. Avoid cocaine and other drugs.Use of birth control pills. If you use any hormone therapy, talk to your doctor about how the hormones may affect your risk of TIA and stroke.
- Risk factors you can't changeYou can't change the following risk factors for transient ischemic attack and stroke. But knowing you're at risk can motivate you to change your lifestyle to reduce other risks.Family history. Your risk may be greater if one of your family members has had a TIA or a stroke.Age. Your risk increases as you get older, especially after age 55.Gender. Men have a slightly higher likelihood of TIA and stroke, but more than half of deaths from stroke occur in women.Sickle cell disease. Also called sickle cell anemia, stroke is a frequent complication of this inherited disorder. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in artery walls, hampering blood flow to the brain.Race. Blacks are at greater risk of dying of a stroke, partly because of the higher prevalence of high blood pressure and diabetes among blacks.
- Full-Blood Test – CReactiveProtein (inflammation), CK-BB (damage of brain cells), Hb (viscosity), glucose lvl
- Doppler’s Test, EEG, Angiography, Evoked Response Test, PET Scan, MRI Scan, CT Scan
- Plavix, Aspirin