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Suggest Treatment For Stroke Of The Right Occipital Lobe

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Posted on Mon, 23 Feb 2015
Question: This might be a bit long. I had a stroke of the right occipital lobe on nov 16, 2014, which the doctor put me on 325 mg aspirin. Doctors did EEG, EKG, Echocardiogram, TEE with Bubble study. hematologist did bloodwork and only found Factor 5 Leiden. The beginning of XXXXXXX 2015 I got clean XXXXXXX of health and went back to work. Well on XXXXXXX 14, 2015 I had a stroke of the right Thalamus wil a mild deficit of the left arm and leg. My aspirin has been changed to 81 Mg and now on 75 mg of Plavix. My primary and Neurologist want me to see my cardiologist for possible hearts issues causing the strokes. I'll see him on Momday. What other possible tests could the cardiologists run?
doctor
Answered by Dr. Geldon Fejzo (38 minutes later)
Brief Answer:
Carotid artery ultrasound recommended

Detailed Answer:
Hello. I have been through your question and understand your concern.

You experienced two episodes of stroke. The screening tests to find the cause is essential for prevention another stroke. What you did till now include cardiac test and blood test.

The next possible causes of stroke is arterial thromboembolism, a possible condition which should explored AND the only condition where antiplatelet drugs (aspirine and plavix) are indicated. The most common artery is the carotid artery where atherosclerosis is a common feature at this age causing stroke. I recommend starting with a carotid artery ultrasound and schedule an MRI of the neck and head.

Another reason carotid artery is probably involved is that both the events were in the right hemisphere, raising more than a simple suspicion on the right carotid artery.

Hope this helps. Please feel free for further questions
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Geldon Fejzo (3 hours later)
I'm sorry, I should have mentioned previously that they did an ultrasound on the carotid and only found minor plaque and no blockage. Also. They did an MRI on the head and Neck and did a MRA on the arteries in the head which the arteries were all clear. It seems that since these are all clear, except for the strokes that are showing, the doctors are thinking the only thing left that could be causing the problem is cardio. But I'm at a lost on what other cardio-related tests can be done. Any suggestions.
doctor
Answered by Dr. Geldon Fejzo (10 minutes later)
Brief Answer:
You have already done most of the required tests

Detailed Answer:
Hello again. At this point once you have already done the essential cardiac test. Still, if there is nothing showing on the vascular and cardiac test you should be on anti platelet drugs (aspirin and plavix) because it is believed that even if you dont find the cause it might be a thromboembolism from an artery.

You can have other exams, but you have done the most important. Maybe MRA is not very sensitive on reveling intracranial small caliber vessel stenosis or occlusion but it rules out the most common conditions causing stroke.

I recommend taking Plavix and aspirin for at least 6 months.

Wish you the best health.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Geldon Fejzo

Neurologist, Surgical

Practicing since :2009

Answered : 337 Questions

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Suggest Treatment For Stroke Of The Right Occipital Lobe

Brief Answer: Carotid artery ultrasound recommended Detailed Answer: Hello. I have been through your question and understand your concern. You experienced two episodes of stroke. The screening tests to find the cause is essential for prevention another stroke. What you did till now include cardiac test and blood test. The next possible causes of stroke is arterial thromboembolism, a possible condition which should explored AND the only condition where antiplatelet drugs (aspirine and plavix) are indicated. The most common artery is the carotid artery where atherosclerosis is a common feature at this age causing stroke. I recommend starting with a carotid artery ultrasound and schedule an MRI of the neck and head. Another reason carotid artery is probably involved is that both the events were in the right hemisphere, raising more than a simple suspicion on the right carotid artery. Hope this helps. Please feel free for further questions