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  #1  
Old 12-08-2005, 03:11 PM
Grits and Hard Toast Grits and Hard Toast is offline
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Pin Strokes

My mother said she had not been feeling well, and asked me to take her to the doctor. She tried to describe what had been happening to her, sort of blacking out, but not passing out. The doctor chalked it up to old age (she is 82).

Then before we could leave, she actually had one of these episodes. I called the doctor back so he could observe her. He diagnosed it as a "pin stroke."

I have tried to google pin stroke, and can't find anything. Even browsing the different sites devoted to strokes, I still can't find the specifics dealing with pin strokes.

Is there perhaps another term that might be more widely used?

The doctor said there was nothing to be done about them. My mother is on high blood pressure medications and takes an aspirin a day. He said that is all there is to do for them. I would like to do a little research on my own about it, but so far can't find a thing.

Does anyone know about pin strokes, and where I might find more info on them?
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  #2  
Old 12-08-2005, 03:27 PM
LiveOnAPlane LiveOnAPlane is offline
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I've not heard of this, either.

However, my mother had a sort of "mini=stroke" a few years back, but completely recovered as far as we could tell. I wonder if this might be what your mother had, as well: Transient Ischemic Attack(TIA)

Just mentioning that I am not a physician and am nervously waiting for someone like Qadgop to come along and severely embarrass me!
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  #3  
Old 12-08-2005, 05:01 PM
Grits and Hard Toast Grits and Hard Toast is offline
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Thank you so much for that link. I looked at that one, then knowing what to look up found many others. What they describe is exactly what happens to her. Her previous doctor had been treating her for petite mal seizures. But in comparing the two, I would say the TIA symptoms match my mother's symptoms much more. closely.

I have to wonder now if all those years she was on phenobarbitol, tegretol, and even valium for epilepsy was a mistake. She had taken those drugs for 30 years, then just stopped one day. Nothing changed. She had those "spells" when she took the meds, and continued to have the "spells" with the same frequency.

I will make copies of the list of symptoms of the two, and take them to my mom's doctor on our next visit. Her current medical emergency information card lists her as an epileptic. I will ask him if that should be changed to say she suffers from TIA's, so if she should have one of these spells in public and is taken to the emergency room, they would have a better idea of how to best treat her.

Thanks again for that information. Correctly identifying what her problem is may make a big difference in her future treatment and care.
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  #4  
Old 12-08-2005, 05:17 PM
Excalibre Excalibre is offline
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Quote:
Originally Posted by Grits and Hard Toast
Then before we could leave, she actually had one of these episodes. I called the doctor back so he could observe her. He diagnosed it as a "pin stroke."
The doctor should have taken more pains to make sure you understood what was being discussed. It would be worth calling the doctor and asking, if you can't find anything elsewhere.

I too would guess that it refers to a Transient Ischemic Attack, but that's pure WAG territory.
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  #5  
Old 12-08-2005, 07:22 PM
Grits and Hard Toast Grits and Hard Toast is offline
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I will be talking with the doctor again when my mother's blood test results are back. I will confirm with him that what he called a pin stroke and TIA are the same thing. I was just hoping to do some research about her condition first, so when I talked with him, I would know what questions to ask, like if this might lead to her having to move to assisted living, rather than the retirement community she has been living in. Or if there were any activities should avoid, etc.

And I think his witnessing her "spell" really shook him up. I have seen her have 100's of these, dating back to when I was 5. Growing up I knew she took medication for it, and really didn't give it much thought, figuring the doctors knew what they were doing. So it caught me a bit off guard to see him so visibly upset. The way he handled the whole thing made me think it was much worse than it is if TIA's are what she is experiencing.

But I will be much better prepared when I talk to him next and will make sure I get all the information I need.
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  #6  
Old 12-09-2005, 04:13 AM
irishgirl irishgirl is offline
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Has your mother had an EKG/ECG recently?
Has she ever had an angiogram or been referred to a cardiologist?
Has she ever had a detailed brain scan?

Aspirin and keeping blood pressure and cholesterol down is usually the plan, but sometimes other things are done, depending on the cause of the TIA.

I'd ask your doctor to look into the cause of these TIAs more closely, especially since your mother might have been having them for so long. There could be a treatable root cause.
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  #7  
Old 12-09-2005, 08:14 AM
brossa brossa is offline
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It is impossible even hazard a guess at a reasonable diagnosis based only on the information you have given us so far. I am not your doctor or your mother's doctor, etc etc. However, to correct a potential misconception about strokes/TIAs:

IF she has had
Quote:
100's of these, dating back to when I was 5
AND her current symptoms are no different, then they are not likely to be strokes or TIAs. A stroke results in destruction of brain tissue and resultant loss of function, which can in many cases be compensated for by surrounding healthy brain tissue. However, this process can not go on forever, and hundreds of strokes, even small ones, would result in dementia or other devestating neurological impairment.
TIAs are 'temporary' strokes where bloodflow is blocked briefly, but then restored as the clot or plaque breaks down. There is no stable 'TIAitis' where a person has hundreds of episodes over a lifetime; they tend to be precursors to actual strokes. Most all of the conditions that cause TIAs are progressive unless treated - with surgery, medication, etc.
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Old 12-09-2005, 09:43 AM
Grits and Hard Toast Grits and Hard Toast is offline
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Quote:
Originally Posted by brossa
It is impossible even hazard a guess at a reasonable diagnosis based only on the information you have given us so far. I am not your doctor or your mother's doctor, etc etc. However, to correct a potential misconception about strokes/TIAs:

IF she has had AND her current symptoms are no different, then they are not likely to be strokes or TIAs. A stroke results in destruction of brain tissue and resultant loss of function, which can in many cases be compensated for by surrounding healthy brain tissue. However, this process can not go on forever, and hundreds of strokes, even small ones, would result in dementia or other devestating neurological impairment.
TIAs are 'temporary' strokes where bloodflow is blocked briefly, but then restored as the clot or plaque breaks down. There is no stable 'TIAitis' where a person has hundreds of episodes over a lifetime; they tend to be precursors to actual strokes. Most all of the conditions that cause TIAs are progressive unless treated - with surgery, medication, etc.
That is what thought as well. But several of the websites state things differently.

"TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average is about a minute. Unlike stroke, when a TIA is over, there's no injury to the brain."

"A TIA is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke."

"The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA and stroke."


http://www.americanheart.org/present...dentifier=4781


"The diagnosis of a TIA indicates that no irreversible neurologic injury has occurred and provides an excellent opportunity to prevent permanent damage."

http://www.aafp.org/afp/991115ap/2329.html

"A transient ischemic attack (TIA) is a temporary loss in brain function when the brain does not get enough blood for a short time. It is a minor stroke that does not cause permanent damage."

http://www.med.umich.edu/1libr/aha/aha_tia_car.htm



In my mother's case, I would say she suffers from dememtia. I had thought it was most likely a result of all those years on those tegretol, dilantin etc, cathing up with her. The doctor currently has her on Exelon and Namenda to help with her memory loss. I can't say it is helping, her memory is getting worse, but he thinks these two drugs are slowing her loss down.

I asked him why he is not reccommending further treatment or evaluation. The sites I have read say patients who suffer from multiple TIA's are given ECG's MRI's CT scans etc, and then put on medication. He felt the current blood pressure medication, Lotensin, Diovan, and Norvasc, were doing what they need to do, and didn't want change that.

I will just add, I am not looking for an actual diagnosis here on the board. I know she needs to work directly with a doctor. But your comments are helping me to decide if I should take her to another doctor for a second opinion. So far all the doctors she has had have been content to let her have these "spells." Nothing they have recommended has stopped them, they seem to feel it is something she will just have to live with. I am wondering if a younger doctor, right out of med school might have some new ideas for her.
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  #9  
Old 12-09-2005, 10:20 AM
irishgirl irishgirl is offline
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Dementia can be caused by brain ischaemia, as well as Alzheimers and other causes. Ischaemic dementia is typified by a step by step progressive deterioration, whereas people with Alzheimers will have good days and bad days and slowly the good days disappear and the bad days get worse. Ischaemic dementia can co-exist with Alzheimers and other dementias. Ischaemic dementia will not respond to the drugs used for Alzheimers, but good blood pressure control, low cholesterol and aspirin might help to slow the progress.

Reading between the lines, I don't think you're happy with the care your mother is currently getting, if that is the case a second opinion or more detailed tests might be in both your interests, if only to put your mind at rest that you have the correct diagnosis and best treatment for her.

If nothing else, an honest, calm chat with her doctor in which you explain what you want done and why wouldn't hurt. He might be basing his diagnosis and treatment on things we don't know, perhaps if he could explain those things to you it would help.
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  #10  
Old 12-09-2005, 01:06 PM
Grits and Hard Toast Grits and Hard Toast is offline
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Quote:
Originally Posted by irishgirl
Reading between the lines, I don't think you're happy with the care your mother is currently getting, if that is the case a second opinion or more detailed tests might be in both your interests, if only to put your mind at rest that you have the correct diagnosis and best treatment for her.

If nothing else, an honest, calm chat with her doctor in which you explain what you want done and why wouldn't hurt. He might be basing his diagnosis and treatment on things we don't know, perhaps if he could explain those things to you it would help.
Yes, you are right about that. The problem is my mother adores this doctor. She doesn't want to see anyone else. There have been several things I haven't agreed with him on, but I just kept quiet, not wanting to upset my mom. On the one hand, it is her health, and I want to respect her choices concerning it. On the other hand, I don't feel she is all there mentally, and I think perhaps I am wrong not to step in if I feel she would get better treatment somewhere else.

Thanks again for the info. It has given me the start I needed so I can better talk to my mom's doctor. I think next I may start a thread in IMHO because I am now in need of some advice on how much I should or shouldn't get involved in her care.
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