Signs of the disease and treatment of transient ischemic attack of the brain

1 The essence of the problem

Transient ischemic attack, or TIA, is a disorder of the cerebral circulation, which is of an acute transient nature. Previously it was called a micro stroke. However, there is a significant difference: in the first case, the symptomatology persists for a maximum of 24 hours, while in stroke symptoms are present for much longer. It is accepted to distinguish two types of TIA:

1. Transient ischemic attack in the vertebrobasilar basin. It occurs in the vast majority of cases.
2. Transient ischemic attack in the carotid basin. It occurs much less frequently than the first species, and accounts for 30% of cases.

Depending on the type of disorder, it will be accompanied by characteristic symptoms. Their severity depends, in turn, on the severity of the disorder. Doctors distinguish 3 levels:

1. Light. The symptomatology persists no longer than 10 minutes.
2. Average. Symptoms are present for more than 10 minutes. They can last several hours, but not more than a day. When the functions are restored, there is no organic symptomatology.
3. Heavy. The duration of the attack is hours. Even after the restoration of functions, there is an organic symptomatology, albeit weakly expressed.

Often people do not give due importance to violations of this kind, especially if the symptoms are poorly expressed and quickly pass on their own. But this attitude towards one's own health is fraught with complications. The fact is that an ischemic attack of the brain can have very serious and dangerous consequences if one ignores the attack. Doctors point out the most common consequences and complications of TIA:

• development of ischemic stroke;
• fatal outcome.

In turn, in the case of a stroke, the following complications can occur:

• decreased mental capacity;
• loss of motor functions;
• speech disturbance, that is, dysarthria.

These neurological defects are extremely stable and difficult to correct.

The prognosis for patients who suffered an attack is unfavorable. Doctors cite such statistics:

1. During the first 24 hours after the attack, stroke occurs in 10% of patients, over the next 3 months - in 20% and in 5 years, stroke develops in 30% of the attackers.
2. Myocardial infarction. It is diagnosed within the next 12 months in 10% of patients.

The ability to recover after a stroke depends on the severity of the attack and the frequency of these attacks.

2 Symptoms of pathology

The attack of the brain is accompanied by characteristic signs, which depend on the area of ​​brain damage and on what vessels were affected during the attack.

So, for ischemia in the carotid basin, the following symptoms are typical:

• mono- and hemiparesis, which are transient;
• hypodesis in the fingers or limbs;
• speech disorders, in particular, inhibition, indistinctness;
• vision impairment on the opposite hemiparesis side.

In addition, patients complain of the inability to arbitrarily perform any action associated with fine motor skills, for example, take a small object. Patients are apathetic, sleepy, their consciousness is confused.

For ischemia in the vertebral-basilar arterial basin, the following symptoms are typical:

• dizziness, which is of a systemic nature;
• vegetative reactions, in particular severe headache in the nape, nausea, vomiting, nystagmus, diplopia;
• disorientation;
• photopsy;
• memory loss, which is temporary( transient global amnestic syndrome);
• drop-off attack.

In addition, this type of violation in some cases may be accompanied by Wallenberg-Zaharchenko or Unterharnshaidt syndrome.

Patients complain of numbness around the mouth and one part of the face, difficulty swallowing, impaired vision of both eyes, trembling of limbs. There is a violation of speech, the tongue is pushed out and goes to the side. A person can not hold himself in a position lying on his side or standing, moving. Against the background of intense headache, uncontrolled vomiting can begin.

3 Factors of development of TIA

The main reason for the attack is local ischemia of the brain, that is, the bleeding of the organ.

Doctors point out the factors that are the prerequisites for the occurrence of such a situation.

Here are the most common of them:

• arterial hypertension;
• diabetes mellitus;
• lipid metabolism disorder;
• bad habits, in particular smoking, excessive consumption of alcoholic beverages;
• hypodynamia;
• overweight, especially obesity;
• increased blood clotting.

Approximately 20% of patients develop TIA against other pathologies, mainly cardiovascular system. These include:

• heart failure due to rheumatic fever;
• cardiopathy;
• myocardial infarction;
• aneurysms;
• atrial fibrillation;
• endocarditis;
• of fibro-muscular dysplasia;
• stratification of arteries;
• congenital heart defects;
• prolapse;
• gradual changes in gynecology in women.

People who have similar pathologies should be very careful about their health, because such patients are at risk.

4 Diagnosis and therapeutic actions

The brain attack is accompanied by symptoms characteristic of other diseases, for example migraine, Meniere's disease, epilepsy, brain tumors, multiple sclerosis. Therefore, in order to establish the correct diagnosis and further assignment of a correct treatment regimen, it is necessary to undergo a comprehensive diagnosis. It includes:

1. ultrasound. The study allows you to determine the level of patency of the vessels of the neck and head. Duplex scanning also helps to evaluate this indicator.
2. MRI of the brain. Tomography will exclude a stroke, as well as identify tumors, if any.
3. Echocardiography. This method provides an opportunity to examine the chambers of the heart for the presence of thrombi.
4. Carotid angiography. It is necessary to assess the condition of the carotid arteries. This study is shown if the data obtained in the course of ultrasound or MRI is insufficient to establish a definitive diagnosis.
5. Electroencephalography. It is indicated in case the doctor suspects that the patient has epilepsy. It allows not to confuse diagnoses and not treat a patient from a non-existent disease.

In addition to hardware techniques, a laboratory test is also used. The patient should take a blood test to determine the level of cholesterol and glucose, as well as assess indicators such as viscosity and clotting.

The diagnosis is made only on the basis of the data obtained during the survey. And only after that the doctor prescribes treatment.

5 Methods of therapy of the disease

In ischemic attack, drug treatment is indicated. Preparations are appointed proceeding from the revealed infringements, gravity of course and degree of a lesion of a brain. The doctor may prescribe the following treatment:

1. Antiaggregants. These are drugs that help reduce the formation of blood clots. They are shown if the blood clot was caused by a thrombus.
2. Hypotensive preparations. They are indicated if the patient has high blood pressure.
3. Anticoagulants. Recommended if the patient has very viscous blood. These drugs help reduce viscosity and clotting.
4. Statins. If TIA developed against the background of atherosclerosis, the preparations of this group are shown. They contribute to the normalization of cholesterol levels and are the prevention of the formation of atherosclerotic plaques on the walls of the vessels.

In certain cases, an operation called endarterectomy is indicated. This is the only way for patients who have more than 70% reduced the lumen of the arteries supplying blood to the brain. The operation consists in the elimination of atherosclerotic formations and, if necessary, artery prosthetics.

6 Prophylactic measures to maintain health

To avoid repeated attacks, as well as consequences and complications, the patient must fundamentally change his habitual way of life. One phrase all preventive measures can be called a healthy lifestyle. In particular, the patient should:

• stop drinking alcohol;
• quit smoking;
• lead an active lifestyle, but given the age;
• adhere to a healthy diet, in particular, do not eat very high-calorie, fatty and cholesterol-rich foods;
• keep the weight.

In addition, it is necessary to make preventive visits to the treating doctor twice a year. The same rules must be followed and people who are in the risk zone.

The doctor will prescribe drugs to reduce the risk of re-attack. In particular, these are medicines to reduce blood viscosity, reduce blood pressure, etc. But in no case should you prescribe drugs yourself, it is done solely by the attending physician. Selfless medication can only hurt your health.