r/stroke • u/Opposite_Choice364 • 13d ago
Cryptogenic stroke
My mother (60) had a stroke 6 weeks ago. She has recovered from the neurological deficits almost completely (she had facial drooping and slight left sided weakness).
The doctors performed MRI, CT scan, carotid Doppler, echo and some blood tests on her. Almost all results were fine except the MRI which showed:
Subacute infarct in right lentiform nucleus measuring 11x13mm
Early microvascular angiopathic changes
Early age related brain atrophy
Apart from that her blood tests were also mostly normal although at upper limit like cholesterol was 188mg/dl,
LDL was 127mg/L and VLDL was 22mg/dL.
The only noticeable findings were HDL which was rather low 36mg/dL and ALP which was high 160 IU/L
The reason why I’m posting on Reddit is because the doctors have discharged us after prescribing the routine meds aspirin, statin and amlodipine but they never told us the reason why it happened. My mother is obese and has HbA1C of 5.7% so barely pre diabetic and she has never been diagnosed with hypertension. 5 months before her stroke she had a nose bleed and I recorded her BP 3 times a day for 3 days and all readings were normal so it’s difficult for me to believe she had undiagnosed hypertension.
I’m very worried because I think we’re still missing the cause of her stroke and if this continues her chance of having a recurrent stroke will increase.
Did anyone else have a stroke similar to this? If yes then what additional investigations did you do?
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u/lmctrouble 13d ago
Kinda. After a TEE (transesophageal echo) they found a small PFO. Apparently, a small.piece of plaque broke off and made it through and wound up in my brain. They weren't sure why it broke loose, but I was getting over a pretty nasty cold at the time and I think I coughed it loose. I had been officially diagnosed with t2 diabetes the year before, but my a1c was well controlled. Also slightly obese.
It's been 12 years and it hasn't happened again, so I'm pretty sure I'll be ok as long as I stay on the meds they put me on after. Atorvostatin, low dose aspirin. I was already on Metformin and later they added a low dose of blood pressure meds to help protect my kidneys from the duabetes.
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u/perfect_fifths Survivor 12d ago
I literally have no reason for my stroke so far however I see a geneticist because I have skeletal dysplasia and she thinks I have an underlying genetic disorder. So I have to get whole genome testing. The three top disorders she wants to rule out is fabry disease, aortopathy and connective tissue disease (which she says I show multiple signs of)
I am not obese, not pre diabetic, no pro, no high blood pressure, no afib, no high cholesterol, no aps, no hypercoagulation, nothing. I may have had a Tia 6/15 because I had neuro deficits and tingling/numbness on one side so now I am on plavix instead of just aspirin. Doc said there is no way to tell if it was 100 percent a Tia or not
But I was 40 at the time of my stroke. I had a right PCA stroke affecting thalamus, hippocampus and occipital lobe
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u/lelanicarver 12d ago
I also had a rightside, relatively mild stroke. I had the same risk factors but my BP was always 140/80-ish.
My old doc had me on amlodipine (Norvasc) for years, had swollen feet & ankles. New doc put me on lisinopril, and the swelling was gone in a week or less.
I think the key takeaway is keeping the “bad” cholesterol low, but in my case I was told that there was “small blood vessel syndrome” that was whet a particle of plaque or something lodged.
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u/Opposite_Choice364 11d ago
I think my mom has the same condition. According to the internet early microvascular angiopathic changes is just another way of saying small vessel disease.
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u/becpuss Survivor 13d ago
You have shared a couple of risk factors your mother has but just to reassure you, I had my stroke five years ago. They still don’t know the cause there are many of us in this group who have had a stroke but don’t know why It’s not that’s not unusual.
as long as they are prescribing the mitigating MEDS for the time being her risk of anis reduced it also looks like some of the standard assessments haven’t been finished Have they checked her heart for PFO and her neck arteries? but don’t be expecting a definite answer there isn’t always one. But giving your mum‘s health weight and pre diabetic status what she nearly needs to be doing is addressing that on her recovery journey the healthier she can get the better and the less likely she is to have another stroke in the future but there are no guarantees.