The diagnosis of transient ischemic attack

Case study:

A 68-year-old man was brought to the emergency department by his family.

During his routine morning walk, he noticed a sudden onset of left facial numbness associated with a dull headache on the right posterior aspect of his head. He was staggering to the right side and feeling unsteady and nauseated, with no vomiting.

He telephoned his wife, who noticed his speech was slow and slurred, but there was no word-finding difficulty. His family immediately took him to the hospital.

There was a history of hypertension, hypercholesterolemia, ischemic heart disease (MI and PCI with a bare-metal stent in 2007), and probable transient ischemic attack (TIA) at the time of cardiac intervention. His medication included atenolol, ramipril, simvastatin, aspirin, and clopidogrel.

Within one hour, the patient’s symptoms had totally resolved. The diagnosis of transient ischemic attack was made, and the patient was discharged home with instructions to contact his healthcare provider (HCP) for follow-up.


Why did the patient’s symptoms totally resolve?

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