Case history
Case history
A 67-year-old man with a prior history of hypertension, diabetes, hyperlipidaemia, and a 50 pack-year smoking history noted rapid onset of right-sided weakness and subjective feeling of decreased sensation on his right side. His family reported that he seemed to have difficulty forming sentences. Symptoms were maximal within a minute and began to spontaneously abate 5 minutes later. By arrival in the accident and emergency department 30 minutes after onset, his clinical deficits had largely resolved with the exception of a subtle weakness of his right hand. Forty minutes after presentation, all of his symptoms were completely resolved.
Other presentations
Presentation of TIA is dictated by the region of brain supplied by the obstructed vessel. Unilateral weakness or sensory deficits may result from ischaemia in the carotid distribution. This presentation represents 67% of all TIAs.[6] Aphasia from ischaemia of Wernicke's or Broca's area occurs in 13% of TIAs.[6] Posterior cerebral artery occlusion may give homonymous hemianopsia, whereas thrombus in the retinal artery leads to amaurosis fugax. Posterior circulation ischaemia may lead to symptoms of ataxia, vertigo, incoordination, cranial nerve deficits, or syncope, and such symptoms are described in 17% of new TIAs.[6] Isolated dizziness is rarely a symptom of TIA or stroke.[7] Lacunar symptoms tend to give isolated sensory or isolated motor deficits but also a number of less common symptom complexes.[8]
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