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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could The Short Term Memory And Slurring Of Words Be Due The Mini Stroke?

I had a MRI of my brain in 2009 because of eyelid surgery I was going to have. This showed a minor stroke that I was not even aware of on the right side. Mt dr. didn t even say anything about this until one year later. The past year or so, i have had trouble thinking of the right words to say...I know what I am thinking but can t find the word. I am retired, 71, don t have any hobbies really. I have been frustrated about this. a neurologist did a CT scan and eeg, which came back normal. He though it was related to depression/anxiety. My new pcp gave me wellbutrin and celexa to help. However, I haven t noticed much improvement. Could this have been caused by that mini stroke? I smoke a bit, don t exercise either. But have some language problems, not forgetfulness. My drs don t think it is dementia, but I worry. Do you have any advice?
Tue, 30 Aug 2016
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Diabetologist 's  Response
Hi
I am Dr Mittal.
I have read your message.
I think I can help you.

First, I do not think that your prior stroke is involved. What you have described is a type of aphasia neurologically speaking. And aphasia is usually caused by a left sided brain problem- not right like you state in your query. Second, if it was truly due to the stroke, the problem would have been since 2009. Brain problems in stroke don't get delayed.
So, I don't think that your prior stroke has anything to do with the issue.

Second, the main causes of aphasia are stroke and dementia. It is not a stroke as per prior CT scan, and not dementia- dementia is memory loss, and from the query, your memory is pretty good- you remember the year 2009 clearly (suggests long term memory is good), and you remember the medicines (suggests short term memory is good as well). So like your doctors, I don't think its dementia either.

However, I disagree with the choice of investigations- the CT has clearly missed your pre existing stroke as well. So I cannot be sure whether it has missed a newer stroke as well. So , I would have ideally suggested another MRI brain (a more sensitive study than CAT Scan) and a CV Doppler. However, I still don't think it is a stroke. A stroke starts suddenly. And you have definitely not said that there was a sudden onset of symptoms. If however you have forgotten to mention this in the query, you should definitely think about stroke and plan a MRI and CV Doppler as suggested before.

Third, a significant history that you have given is the loss of work and lack of hobbies and physical exercises. I wont call it depression or anxiety. And therefore I don't think your medicines will work either. In your case, the age old adage- all work and no play makes Jack a dull boy- is probably most appropriate.
So my suggestion is that you need to stop smoking and get some company and daily activities. It may sound odd to you but inactivity does take its toll. I don't think medicines are needed in your case. You just need to fill in your time with more activities so that your mind is active again.

I have tried to make it as simple as possible for you to understand. Feel free to ask another query with a specific doubt based on the information I have given you. I would be happy to help you further. Best of luck, Dr Mittal
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Could The Short Term Memory And Slurring Of Words Be Due The Mini Stroke?

Hi I am Dr Mittal. I have read your message. I think I can help you. First, I do not think that your prior stroke is involved. What you have described is a type of aphasia neurologically speaking. And aphasia is usually caused by a left sided brain problem- not right like you state in your query. Second, if it was truly due to the stroke, the problem would have been since 2009. Brain problems in stroke don t get delayed. So, I don t think that your prior stroke has anything to do with the issue. Second, the main causes of aphasia are stroke and dementia. It is not a stroke as per prior CT scan, and not dementia- dementia is memory loss, and from the query, your memory is pretty good- you remember the year 2009 clearly (suggests long term memory is good), and you remember the medicines (suggests short term memory is good as well). So like your doctors, I don t think its dementia either. However, I disagree with the choice of investigations- the CT has clearly missed your pre existing stroke as well. So I cannot be sure whether it has missed a newer stroke as well. So , I would have ideally suggested another MRI brain (a more sensitive study than CAT Scan) and a CV Doppler. However, I still don t think it is a stroke. A stroke starts suddenly. And you have definitely not said that there was a sudden onset of symptoms. If however you have forgotten to mention this in the query, you should definitely think about stroke and plan a MRI and CV Doppler as suggested before. Third, a significant history that you have given is the loss of work and lack of hobbies and physical exercises. I wont call it depression or anxiety. And therefore I don t think your medicines will work either. In your case, the age old adage- all work and no play makes Jack a dull boy- is probably most appropriate. So my suggestion is that you need to stop smoking and get some company and daily activities. It may sound odd to you but inactivity does take its toll. I don t think medicines are needed in your case. You just need to fill in your time with more activities so that your mind is active again. I have tried to make it as simple as possible for you to understand. Feel free to ask another query with a specific doubt based on the information I have given you. I would be happy to help you further. Best of luck, Dr Mittal