Why do I have strokes, aneurysms, and other neurological problems for more than four years?

Question

Hi doctor,

I have had four-plus strokes in the last four years. After my first stroke, the neurologist said I had two lesions on the brain that looked autoimmune-related and an abnormal white matter for my age. The last time I had strokes was three years ago. However, I had neurological issues well before my strokes started. My first stroke that occurred four years ago affected my entire left side. Two years back, I started having other neurological issues not stroke-related, and my neurologist just said it is autoimmune related. One year ago, I began having pain in my spine, and it would shoot down my shoulder and my right arm. It all started with migraines, and I lost vision in both eyes for half an hour, along with kidney infections and pneumonia every year for the past five years. I also lost bowel control and could hardly walk and get out of bed, and this went on for months, then stopped for a few months, and then new symptoms started. I also have double vision, dizziness, numbness on the right side of the face, trouble breathing, problems in swallowing and digestion, issues in finding words or pronouncing words, and my memory worsened. I also suffer from stomach hernia, inflammation of the pancreas, and thyroid problems, and the cause is not known. Had an MRI and CAT scan done, and after the CAT scan suffered a seizure. After which, I slept for three days and then woke up with right arm numbness. I was having trouble talking and recalling words and started stuttering. Immediately went to the hospital, and the doctor said it was not a stroke and was a neurological issue. My spinal tap results were average except for high protein levels. My doctors thought it would be antiphospholipid syndrome (blood disorder), but the blood results showed negative. My blood pressure was normal, even before I took medications and my cholesterol levels were also a little elevated. No one has been able to help me. I went from healthy to super sick with strokes, aneurysms (one in the head, two in the heart), and neurological problems. Currently, I am taking Tramadol 50 mg three times a day for my pain and thyroid medications. I am also taking cholesterol and blood pressure medications and other medications like blood thinners, Clonazepam, Cymbalta, Lyrica, Gabapentin, etc. I am susceptible to drugs. Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. I passed carefully through your question and your reports (attachment removed to protect the patient’s identity). I would suggest performing further tests to investigate the possible cause of stroke.

In this regard, I would suggest the following:

1) A transesophageal echocardiogram (TEE) of the heart to exclude cardiac issues.

2) Homocysteine plasma levels.

3) Anti-thrombin III levels.

4) Anticardiolipin and antiphospholipid antibodies titer.

5) Protein C and protein S plasma levels.

If all the above tests are standard, I suggest genetic testing for CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts).

The small aneurysm is not related to the stroke, and it has a shallow risk for rupture. So, there is no need for surgery or endovascular treatment. Just blood pressure monitoring would be enough. You are taking blood thinners, and there is an increased risk of rupture. And the eye field problem is caused by the stroke.

Kindly revert in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern. Multiple sclerosis has a different pattern in MRI (magnetic resonance imaging), so I do not think this is the case. Anyway, after a year, I suggest a follow-up with brain MRI (magnetic resonance imaging).

Hope you get well soon.

Kindly revert in case of further queries.

Why do I have strokes, aneurysms, and other neurological problems for more than four years?

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