Stroke symptoms repeatedly come & then improve??

Posted by sonya_nc @sonya_nc, Dec 24, 2020

My 80 yr old mom had what was first dx as a stroke last week- confusion/ diff walking/ left side weakness& vision impairment. She has been on zaralto for AFib for several yrs and never any ‘stroke like’ issues. CT did not show bleed/ angiogram also clear/labs normal. The next day while inpt, strength & mobility returned & vision improved. So discharged w/ TIA DX. One week later- episodic return of all ‘stroke’ previous symptoms and then they resolve again. We are confused- discharging dr said TIA and now follow up dr says stoke. Has anyone experienced this ongoing random stroke symptom presentation w/ ‘recovery’ and then repeated episodes? What questions should we be asking??
Thank you.

@sonya_nc, I can imagine that this is worrisome and it can be confusing to know what questions to ask medical professionals to be proactive and get the care your mom may need. @musicflowers4u may have some experience to add.

According to this information on Mayo Clinic's website, the stroke symptoms coming and resolving is typical of transient ischemic attack (TIA).
– Transient ischemic attack (TIA) https://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack/symptoms-causes/syc-20355679

Here's an excerpt from the article:
"You may have more than one TIA, and the recurrent signs and symptoms may be similar or different depending on which area of the brain is involved. Since TIAs most often occur hours or days before a stroke, seeking medical attention emergently following a possible TIA is essential. Seek immediate medical attention if you suspect you've had a transient ischemic attack. Prompt evaluation and identification of potentially treatable conditions may help you prevent a stroke."

This video with Dr. Brott might also help you to know what questions to ask.
– Video Q&A about Stroke Prevention https://connect.mayoclinic.org/webinar/on-facebook-live-lets-talk-stroke-prevention-with-thomas-brott-md/

Is your mom at home now? What did the followup physician say to do if she experiences the symptoms again? Sounds like you should contact them.

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@colleenyoung

@sonya_nc, I can imagine that this is worrisome and it can be confusing to know what questions to ask medical professionals to be proactive and get the care your mom may need. @musicflowers4u may have some experience to add.

According to this information on Mayo Clinic's website, the stroke symptoms coming and resolving is typical of transient ischemic attack (TIA).
– Transient ischemic attack (TIA) https://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack/symptoms-causes/syc-20355679

Here's an excerpt from the article:
"You may have more than one TIA, and the recurrent signs and symptoms may be similar or different depending on which area of the brain is involved. Since TIAs most often occur hours or days before a stroke, seeking medical attention emergently following a possible TIA is essential. Seek immediate medical attention if you suspect you've had a transient ischemic attack. Prompt evaluation and identification of potentially treatable conditions may help you prevent a stroke."

This video with Dr. Brott might also help you to know what questions to ask.
– Video Q&A about Stroke Prevention https://connect.mayoclinic.org/webinar/on-facebook-live-lets-talk-stroke-prevention-with-thomas-brott-md/

Is your mom at home now? What did the followup physician say to do if she experiences the symptoms again? Sounds like you should contact them.

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Thank you for the reply. Yes, she has been home for a week. We are confused given the discharging dr said TIA diagnosis and the follow up dr said no, this was a stroke. We feel it odd that the weakness/ confusion/ visual impairment goes and comes during a 24 hr period. Felt we must be missing something or not clearly communicating our questions.

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@sonya_nc

Thank you for the reply. Yes, she has been home for a week. We are confused given the discharging dr said TIA diagnosis and the follow up dr said no, this was a stroke. We feel it odd that the weakness/ confusion/ visual impairment goes and comes during a 24 hr period. Felt we must be missing something or not clearly communicating our questions.

Jump to this post

@sonya_nc

My mom started having TIAs when she was around you mom's age. They do not show up on brain scans. Basically diagnosed on symptoms. A blood thinner is all that may help. My mom kept having them and the older she got the more frequently she had them. Mom passed away this past August of brain hemorrhage from a major stroke at age 92 1/2. She had a mild stoke in 2016 then another in December of last year and one this past June. She had many TIAs also known as mini-strokes in between. Mom would have horrible headaches and her vision was effected with both the TIAs and mild strokes. With the mild strokes the symptoms went away slower and usually speech impairment with both too. The speech usually sounds like a film being run backwards or a baby babbling. They always effected her left side and after the mild strokes her left side remained weak. If mom had the headache and vision problem for a few hours I did not take her to the ER, but if she had the droopy mouth and speech problem or other stroke symptoms I took her. They can use a clot busting drug if need, but it has to be done within a certain amount of time after stroke symptoms begin.

My mom was in a nursing home from this past January until her death in August. With covid going on we were not able to visit her at the nursing home since March.. we could during the 3 hospital stays she had at the hospital. This last time she had symptoms several days before they took her to the hospital. I would call and no one from 3 phone number would answer me or my brother. I called every day. I finally got through using my husbands phone very late in the day. I think they were using caller ID to dismiss me calling and my brother too. It was the activities director that answered the phone and she was always good to my mom. She had not seen mom in a few days. She taking the phone to mom and she said she had heard that my mom has a UTI and was a little confused and having trouble speaking. I told her mom usually only gets confused with a UTI and no speech problem. She came into the room and discovered my mom could not talk.. just making noises and listing to one side. She told me she was going to have the nurse evaluate my mom and she would call me back. They called me back in a few minutes and said she was being taken to the hospital. There is no neurosurgeon they could get her to for the brain hemorrhage and I was told they probably would not do anything because of her age if they could find one… we have such great medical care in South Georgia 😬. I am thinking they would not do anything because of her heart… she had Mobitz type 2..bradycardia. There was nothing that could be done.. nor did mom want anything done and we transferred her to hospice and me and my oldest brother took turns staying with her until she passed.

Some other things that may come up… Sometimes with a urinary track infection or even pneumonia she would be disoriented. That tends to happen in the elderly. So if she disoriented or just not acting like herself she may have an infection of some kind. Dehydration can also cause them to act a bit differently. Getting mama to drink enough was always hard. My husband helped me take care of her for two years. It broke our hearts to place her in a nursing home, but I could not physically take care of her being she could not walk after the stroke. The nursing home was for rehab, but she did not respond to it.

If I can help you in any way just ask.

ZeeGee

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@fourof5zs

@sonya_nc

My mom started having TIAs when she was around you mom's age. They do not show up on brain scans. Basically diagnosed on symptoms. A blood thinner is all that may help. My mom kept having them and the older she got the more frequently she had them. Mom passed away this past August of brain hemorrhage from a major stroke at age 92 1/2. She had a mild stoke in 2016 then another in December of last year and one this past June. She had many TIAs also known as mini-strokes in between. Mom would have horrible headaches and her vision was effected with both the TIAs and mild strokes. With the mild strokes the symptoms went away slower and usually speech impairment with both too. The speech usually sounds like a film being run backwards or a baby babbling. They always effected her left side and after the mild strokes her left side remained weak. If mom had the headache and vision problem for a few hours I did not take her to the ER, but if she had the droopy mouth and speech problem or other stroke symptoms I took her. They can use a clot busting drug if need, but it has to be done within a certain amount of time after stroke symptoms begin.

My mom was in a nursing home from this past January until her death in August. With covid going on we were not able to visit her at the nursing home since March.. we could during the 3 hospital stays she had at the hospital. This last time she had symptoms several days before they took her to the hospital. I would call and no one from 3 phone number would answer me or my brother. I called every day. I finally got through using my husbands phone very late in the day. I think they were using caller ID to dismiss me calling and my brother too. It was the activities director that answered the phone and she was always good to my mom. She had not seen mom in a few days. She taking the phone to mom and she said she had heard that my mom has a UTI and was a little confused and having trouble speaking. I told her mom usually only gets confused with a UTI and no speech problem. She came into the room and discovered my mom could not talk.. just making noises and listing to one side. She told me she was going to have the nurse evaluate my mom and she would call me back. They called me back in a few minutes and said she was being taken to the hospital. There is no neurosurgeon they could get her to for the brain hemorrhage and I was told they probably would not do anything because of her age if they could find one… we have such great medical care in South Georgia 😬. I am thinking they would not do anything because of her heart… she had Mobitz type 2..bradycardia. There was nothing that could be done.. nor did mom want anything done and we transferred her to hospice and me and my oldest brother took turns staying with her until she passed.

Some other things that may come up… Sometimes with a urinary track infection or even pneumonia she would be disoriented. That tends to happen in the elderly. So if she disoriented or just not acting like herself she may have an infection of some kind. Dehydration can also cause them to act a bit differently. Getting mama to drink enough was always hard. My husband helped me take care of her for two years. It broke our hearts to place her in a nursing home, but I could not physically take care of her being she could not walk after the stroke. The nursing home was for rehab, but she did not respond to it.

If I can help you in any way just ask.

ZeeGee

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Thank you for your reply. My condolences for the loss of your mother.

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I am now 66 years old. In 2012 I was diagnosed with TIA (I had right side impairment – loss of fine motor skills, speech impairment and right foot drag). I went through hand therapy and OT therapy and regained use of my hand, right leg and speech returned. In 2017 these impairments returned (much worse this time) and I was diagnosed with Ataxia. What I still don't understand though, is I have done a great deal of reading on the subject of Ataxia, and what I have read does not agree with diagnosis of Ataxia – because all of my symptoms are on one side (true Ataxia has symptoms on both sides of the body) – I have been on Losartan and Low Dose Aspirin (daily) as Blood Thinner – since the TIA diagnosis in 2012. Doctors I have questioned about this do not answer me. Quite frankly, I have been passed around like a "hot potato" by doctors I have reached out to for help.

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@colleenyoung

@sonya_nc, I can imagine that this is worrisome and it can be confusing to know what questions to ask medical professionals to be proactive and get the care your mom may need. @musicflowers4u may have some experience to add.

According to this information on Mayo Clinic's website, the stroke symptoms coming and resolving is typical of transient ischemic attack (TIA).
– Transient ischemic attack (TIA) https://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack/symptoms-causes/syc-20355679

Here's an excerpt from the article:
"You may have more than one TIA, and the recurrent signs and symptoms may be similar or different depending on which area of the brain is involved. Since TIAs most often occur hours or days before a stroke, seeking medical attention emergently following a possible TIA is essential. Seek immediate medical attention if you suspect you've had a transient ischemic attack. Prompt evaluation and identification of potentially treatable conditions may help you prevent a stroke."

This video with Dr. Brott might also help you to know what questions to ask.
– Video Q&A about Stroke Prevention https://connect.mayoclinic.org/webinar/on-facebook-live-lets-talk-stroke-prevention-with-thomas-brott-md/

Is your mom at home now? What did the followup physician say to do if she experiences the symptoms again? Sounds like you should contact them.

Jump to this post

I would ask the Dr to do a brain scan to check for a partial blockage in one of the small vessels in the brain

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Thanks, but brain scan was done in 2017 radiologist found I had a "small cavernous hemangioma w/bleed that would not account for all your symptoms and is too small to warrant surgery." Doctor said I should get another brain scan in late 2021 to monitor the cavernous hemangioma.

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I hope they find what ever is causing it before it becomes Major there has to be something they are missing or the tests can't detect being it is episodic as that is really hard to detect If they could do a scan when it is happening it may show up.

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My mother had stroke after stroke after stroke starting in her early 80's.. Most of them were "transient" meaning she would lose her ability to speak ( her most usual presentation, but also loss of gross motor, vision, etc…) for a few moments or hours. Mom flat refused to go to the doctor or to have us report the symptoms. Once early on when the symptoms were obvious and prolonged, I called 911 and they came and transported her to the hospital. She slipped ever more deeply into non-responsiveness until the staff said she was probably gone, but we could try something called TPA (?) – basically pumping a clot breaking fluid through her system to see if the blockage could be shifted. Miraculously, it did! Mom came back over the next hour and was ready to go home the next day. She always thought she was the same. She wasn't; she became increasingly self centered and indulgent ( boxes of chocolates every day, rooms full of new clothes, eating out at very expensive restaurants….) and tyrannical. Her knickname had long been "She who must be obeyed." When she was in her full faculties, she was an effective and beneficent dictator. As her stroke damage (though transient) progressed, that knick name came to assume very wicked and evil dimensions. It became unquestioning obedience or be kicked out of the will ( large estate), making very poor money decisions, and being very resentful of my dad who in his gentle dementia, wanted to be with her. His presence interfered with Mom's very active ladies' events ( DAR, church, lunch out, shopping, concerts) . As the one with medical POA, I risked Mom's rejection by revealing to the doctors what was going on; reporting what her driving was like (her motto was "just because I can't talk doesn't mean I can't drive….), what was going on at home with the medications (!), and with Dad's being abandoned for long hours at a time when his doctor said he could not be left alone. I wasn't terribly concerned about being thrown out of Mom's good graces, assuming that my brothers would pick up the reins and keep reasonable limits on Mom, keeping the finances on a steady course, and getting the needed care staff to help take care of Dad. They didn't. They didn't dare cross her for fear of losing their share of the estate. This downward spiral continued. The strokes kept coming. Each time her rebound was a bit lower. I don't understand how a body can have so many strokes and still keep functioning but she did. She finally died last January at age 92 from general body shut down. The financial fall out for me was horrific.

Lessons:

1. Yes, a person can go on and on and on having strokes. Some may be transient, but they don't come with a label; you won't know until things play out. All are worth doctor notification. The person may think they are the same afterward, but they probably will have diminished capabilities with each event. They will need protection from their own poor decisions and personality changes.
2. Make sure you have your legal papers in order and locked in a way that won't be rocked by a stroke broken mind. Make those papers long before things get bad (like maybe when they are in their mid 70's, they are handling their own finances well, and seem absolutely fine.) But beware – my POA was put in place when my parents were still with it, yet when push came to shove, Mom was able to override it and my brothers were more than happy to accommodate her. The result was terminating my father, and lopping off my third of the inheritance to share between themselves. I NEVER would have anticipated such outcomes.
3. Try to make sure you and your siblings (or whoever else may have a voice in the end of life management issues) have a clear understanding of what the goals and values will be during this difficult time of life.
4. Don't be afraid to get help from authorities when the truth of the situation calls for it. I should have called adult protective services to protect my father, but couldn't quite believe what was actually being perpetrated, until it was too late.

The daughter

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WOW That sounds like my Mother in her last 6 years she suffered form what everyone said was Alzheimer's for many years then the last 6 she got really out of hand and she had heart problems were she would black out for a few seconds to a few min and I think that may have damaged her brain from the lack of blood and she became very violent and I finally had to put her in a nursing home. It sounds like maybe your mon may have suffered brain damage also during the time of the stroke when blood was not flowing to all the brain. Its really sad to see that happen myself I would rather die than have a stroke and be disabled for life

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Thanks to everyone for your thoughtful replies. My mom is back to her pre TIA ‘normal’ w/ no deficits. She is on her regular meds and requires no assistance. Our mystery continues.

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@speechless623

Thanks, but brain scan was done in 2017 radiologist found I had a "small cavernous hemangioma w/bleed that would not account for all your symptoms and is too small to warrant surgery." Doctor said I should get another brain scan in late 2021 to monitor the cavernous hemangioma.

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Are you getting CT or MRI?

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