Hi Amy :hugbetter:
I'm very sorry to hear about your TIA experience... It must have a been very scary to go through both for you and your family...
Now, TIAs or Transient Ischemic Attacks (or mini-strokes as they are sometimes called) are caused by a temporary blood flow disturbance to a specific part of the brain. This disturbance in blood flow results in a brief decrease in brain function of that specific part of the brain and it is what produces the stroke-like symptoms we experience during TIAs.
Transient Ischemic Attacks are as much a medical emergency as a full-blown stroke is, regardless of the fact that in a TIA the disturbance resolves by itself in a short amount of time (whilst in an actual stroke it doesn't) . The reason for that being that sometimes TIAs can be warning signs of impending stroke. Now I realize that is panic-inducing statement, so bear with me for a little while as I try to explain what is meant by it! About a third of the people that experience TIAs go on to live perfectly normal lives and never have another, another third of the people have recurring TIAs and the remaining third go on to have a stroke. That is NOT to say that once someone has a TIA they are necessarily going to have a stroke or are at high risk for a stroke. Doctors take into consideration a number of risk factors including the duration of the TIA, i.e. a TIA lasting around 60 minutes is usually deemed more "dangerous" than one lasting less than 60 minutes, blood pressure during an attack, symptoms the TIA caused (i.e. weakness on one side or speech disturbance but no weakness etc etc) and any underlying medical conditions that may cause one's blood to coagulate more easily.
On that note, did you find out if your doctor tested you for APS after all? If you do have APS please bear in mind that it is usually a very very treatable disorder and sometimes even a baby aspirin can be enough to provide symptom relief. If you haven't been tested for APS it might be an idea to talk to your primary doctor about getting tested. You can find more information on APS and the blood tests used to test for it on the "Related Conditions" part of this forum:
Something called vasculitis could also cause TIAs in lupus patients; vasculitis is a pretty general term and in layman's terms it usually refers to a disease process that involves the inflammation of blood vessels. There are many different forms of vasculitis, but the important thing here is that the blood vessel inflammation caused by vasculitis can result in a narrowing of those blood vessels that can sometimes be enough to disrupt blood flow to specific parts of the body. Vasculitis can affect blood vessels anywhere in the body and it can sometimes result in TIAs.
The reason I am mentioning this here is that if one's TIAs are APS related (i.e. due to a transient blockage of blood vessels caused by a clot; the emphasis here being on the word transient!) then more often than not there will be no findings on an MRI, MRI with contrast and/or MRA (that is Magnetic Resonance Angiography instead Magnetic Resonance Imaging) when the TIA has passed as the clot itself has resolved and blood flow will have been restored. If the TIA has lasted for a long time and has managed to destroy a good number of nerve cells in the area then this might show up on an MRI, but again it's not 100%. I don't really know if "damage" done by TIAs caused by vasculitis will show up on an MRA, perhaps someone who knows more about this will come along to answer that though!
What I'm trying to say is that if the contrast MRI turns up nothing, then that does NOT mean you did not have a TIA. What it does mean is that the TIA did not leave any lasting "damage" and TIAs often don't.
I had my first TIA about two years ago and it was a strange experience. It was very minor at first, just some sudden right sided weakness that went away on its own within 15 minutes or so and even though I went to A&E right away and my rheumatologist was called no one actually recognized the episode as a TIA. My docs thought it might be central nervous system inflammation from lupus and I didn't really know anything about TIAs so I didn't really have an opinion at the time (boy; that's changed now though! :lol: )! This experience repeated itself 2-3 times the following day and two days later I had a bizzare transient episode of speech loss (which we know now was transient aphasia from a small clot) and a transient loss of vision in one eye (which we now know was transient amaurosis fugax again from a clot). On the third day my right side became completely paralyzed, I couldn't speak properly, or swallow, my face on the right side "dropped" from the paralysis and that time it just wouldn't go away. My family called my neurologist and they had the excellent thinking of putting me on the line so he could hear how this affected my speech and he dropped everything with his team, called my rheumy and they all met us at A&E about 10 minutes later. Thankfully this was a TIA too, instead of a full blown stroke, but it lasted about an hour and a half; and the MRI/MRA I had done then during this attack is the only imaging study that has ever shown a TIA-related embolus (as the other ones were done after the TIAs had resolved). Now because I had recurrent TIAs and in a worsening pattern it was deemed I was high risk for a stroke and I was started on heparin shots to prevent this. The shots stopped the TIAs and the impending stroke the docs were so sure would follow...!
Having such an experience is definitely scary, but this is something that can be dealt with and controlled and it can go away with the proper treatment!
If you have another TIA do go to the hospital immediately for assessment, tests and possibly treatment! It really is a medical emergency!
I hope the contrast MRI went ok!
You're perfectly right about wanting to have some answers so this can be dealt with. I hope you get them very very soon. :blush:
Sending loads and loads of strengthening hugs your way :grouphug2: :grhug:
Ps. Here's some links with information about TIAs: