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Q. I feel weak, numb, and almost pass out. Do my CTA reports show the cause?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 03, 2017

Hello doctor,

I have been feeling weak, numb, and almost passing out throughout the day randomly for a month. I had a CTA in the ER, and they sent me home with this report. And they said to check with neurology, but not to worry. I have read and it says not to worry unless you are symptomatic, which I think I am. I have had a year of random anxiety, confusion, pain, and stroke like episodes.

The neck CTA report read, no CTA evidence for internal carotid artery stenosis, occlusion, or dissection. Mildly hypoplastic right cervical vertebral artery without evidence for dissection, stenosis, or occlusion. Evidence for prior right hemithyroidectomy. The head CTA read, no CTA evidence for large vessel occlusion secondary to embolism or acute thrombus. Hypoplastic right intracranial vertebral and basilar arteries. Severe hypoplasia of the right posterior cerebral artery P1 segment with a patent right posterior communicating artery supplying blood to the right posterior circulation.

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Hi,

Welcome to icliniq.com.

  • You have hypoplastic right intracranial vertebral and basilar arteries and severe hypoplasia of the right posterior cerebral artery (the P1 segment). But with a patent right posterior communicating artery, which is supplying blood to the right posterior circulation. In my opinion, this is the most likely cause of your dizziness and near syncope.
  • Before I explain that to you, I need to know if you have been diagnosed with any other medical illness or you are taking any medications due to any reason? Do you have a family history of people having stroke type symptoms at a young age or do you suffer from migraine headaches (officially diagnosed)?

Thank you.

Revert with more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Hi doctor,

Thank you for replying. Yes, I suffer from hemiplegic migraines for years. My face falls, and I go weak and then it bounces back. I have a factor V heterozygous mutation, so I clot, but only one gene mutation. What can be done about this? Am I going to die? Can they put stents in? This whole year, the doctors have been giving me medicines for anxiety and no one will listen.

#

Hi,

Welcome back to icliniq.com.

  • I would want you to see a neurosurgeon because you have vessels with low plasticity. This could be due to migraine headaches or the other way around. I am not sure if you have a neurologist or not, but this finding should be communicated to him.
  • Also, if you form clots and have factor V mutation and along with this new information on board, I strongly feel you should be on a blood thinner. It seems like the posterior circulation has still a good supply through collateral circulation (at least that is what the report outlined), so stent may not be needed.
  • Having said that, it would be at the surgeon's discretion and your decision. Please let me know if you have any further questions and concerns. Thank you.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician


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