The limbs are weak but recover quickly, what went wrong?

Author: Liu Yumei, Chief Physician, Xuanwu Hospital, Capital Medical University

Reviewer: Chief Physician of Huayang Capital Medical University Xuanwu Hospital

A month ago, 56-year-old Aunt Wang suddenly felt powerless on one side of her body, but recovered quickly. Although this was strange, Aunt Wang did not take it seriously, thinking it was because she was too tired recently. However, a month later, Aunt Wang was sent to the hospital because of a large area of ​​cerebral infarction.

After understanding the situation, the doctor told the family that when Aunt Wang first experienced limb weakness, it was actually a transient ischemic attack, which was a warning sign of cerebral infarction. She should have gone to the hospital for examination and treatment in time.

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1. What is a transient ischemic attack?

Transient limb weakness, also known as "transient ischemic attack", refers to transient neurological dysfunction caused by focal ischemia of the brain, spinal cord or retina, and is closely related to ischemic stroke. Transient ischemic attack is a precursor to cerebral infarction. The symptoms during the attack are very similar to those of cerebral infarction, but the duration is shorter, generally more than ten minutes, and usually recovers within 1 hour, and the longest does not exceed 24 hours, and no symptoms remain during the remission period.

Transient ischemic attack is a serious "stroke warning" event that requires urgent intervention. It is a very serious cerebrovascular emergency. The main harm is to affect the blood supply to the human head and cause brain cell damage. Patients may experience a series of symptoms, such as sudden numbness and weakness of hands, feet or face, unilateral or bilateral blurred vision, dizziness, slurred speech, crooked corners of the mouth, sudden and unexplained severe headache, etc.

During a transient ischemic attack, if the occlusion of the blood supply artery is not treated promptly, or the symptoms are not relieved for more than 24 hours, it may cause brain cell necrosis and lead to the loss of corresponding regional brain functions, which can be life-threatening in severe cases.

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About 1/3 of patients with transient ischemic attacks will eventually develop strokes. Patients with a history of transient ischemic attacks are 10 times more likely to have cerebral infarction than those without. Most patients with transient ischemic attacks will develop strokes within the next 90 days, with more than 50% of them occurring in the first two days.

From this point of view, we should not ignore the symptoms just because they disappear quickly. Instead, we should go to the hospital as soon as possible and have the doctor find the cause and prescribe preventive medication for the related risk factors for cerebrovascular disease to prevent cerebral infarction.

In addition, after a transient ischemic attack, some patients are extremely worried about the recovery of the disease, which leads to negative emotions such as anxiety, suspicion, depression, etc. These negative emotions will affect the neuroendocrine system, aggravate the changes in the psychological state, and thus lead to the occurrence of other diseases.

2. What tests should be done for transient ischemic attack?

Once there are symptoms of transient ischemic attack, the patient should go to the hospital as soon as possible, and the clinician should make a preliminary diagnosis based on positioning and qualitative analysis, and conduct relevant examinations such as hematological indicators, CT or magnetic resonance imaging to rule out hemorrhagic diseases, determine the location and extent of cerebral infarction, and carry out corresponding emergency treatment.

After the acute phase, patients can undergo cerebral-carotid artery ultrasound examination, cerebral blood perfusion, etc. to more accurately determine whether there are atherosclerotic plaques, thrombi, stenosis and occlusive lesions related to cerebral ischemia.

For patients suspected of having a stroke, the preferred examination method is a head CT scan, which can immediately determine whether the patient's stroke is ischemic or hemorrhagic.

In short, transient ischemic attack is a relatively complex disease that is easily overlooked. In fact, transient ischemic attack is a warning sign of cerebral infarction and a high-risk factor for stroke, and should be taken seriously. Once transient ischemic attack occurs, you should seek medical attention in time, actively cooperate with the doctor to screen the cause and your own risk factors, and receive relevant treatment to prevent sudden stroke after recovery from the disease.