Tia

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naserdoc

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i had my inpatient admitted from ER with history of TIA ( rt sided weakness and slurred speech ) for 20 minutes at home. hes K/O AF was not on warfarine , when i saw him he was completely passed the attack and there was no further signes noticed. CT brain was negative on first and second days.
5 days he was put on warfarine 4 mg, lovenox 1mg/KG and kept his old ASA 81 mg , his INR never raised more than 1.4 , !! oon the 5th day he developed another attack of TIAn with similary signs,. CTS also showed no further changes ( bleeding or infarction) and no atrophic changes. carotid was normal. i stopped his ASA and now hes ion titrating higher dose of warfarine and heparine 5000 SC,
does any body has any further comment what should be done more?
 
What was his ABCD2 score? If his carotids were normal, maybe get a CT angio. Consider adding dipyridamole if he will tolerate it, otherwise it seems aa though he is medicated to the eyeballs. His next one will be a bleed! Is he on a statin? Put him on one if he isn't. Was he in hospital for 5 days, or had he been discharged?
Depending on his risk stratification send him home to have another one or keep him there for a bit longer to have another one.

Finally, why are you asking me? I'm just an ambulance driver!
 
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