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Dr Uzair
Dr Uzair, Doctor
Category: Neurology
Satisfied Customers: 9918
Experience:  MBBS, FCPS (R) General Surgery, 5 years experience in Emergency Medicine.
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About 5/6 years ago I fell down some stairs, and although I

Customer Question

About 5/6 years ago I fell down some stairs, and although I had clear recollection that I did not bang my head I woke up with a speech impediment - I just could not pronounce words properly. There was no movement restriction or other symptom, but I was admitted to the Royal London Hospital where a neurologist did a CT scan and found some cerebral haemorrhageing (subdural I think). The speech problem went away quite quickly but I remained in hospital (I was moved to UCH and then Queen Square) for observation for2/3 weeks. No surgery was reuired - the haemorrhage cleared gradually and a final MRI scan showed nothing.
Just over a week ago, I was having dinner with a friend at a London restaurant (after a tiring day of travelling and meetings) when I found that I could not speak the names of the dishes on the menu properly. In view of my previous experience, I made an appointment with my consultant neurologit (Dr Paul Jarman) but he cannot see me until 9th May. Last Thursday I saw my GP to request a referral (for BUPA) and he described my experience as a mini-stroke and said that guidelines (I am not sure who's) meant that I should not drive for 30 days (a huge problem as I live in the middle of nowhere) and prescribed 75mg of aspirin a day. I am not happy about this and seek another opinion - there has been no repetition (the event only lasted 10 minutes or so) and I feel fine. What do you think? I am male and 73 years old.
Submitted: 2 years ago.
Category: Neurology
Expert:  Shantal-Mod replied 2 years ago.
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Expert:  Dr Uzair replied 2 years ago.
Hello and thanks for the query.
The TIA and Stroke management guidelines of the Stroke Foundation dictate that a person who has suffered from a Transient Ischemic Attack (TIA) or a mini stroke should not drive for at least 2 weeks, the month long restriction is for individuals who have had an actual stroke and have survived it.
It has also been postulated by several studies that 10% of TIAs will develop stroke within 90 days, half of which will occur in the first two days following the TIA, also one third of the people with TIA later have recurrent TIAs and one third have a stroke because of permanent nerve cell loss, so your GP is being careful.
Having a stroke while driving can put definitely put your life at risk along with other people traveling in the car with you and those around you.
I would suggest that you comply with the "2 weeks no driving" recommendation and travel by public transport, taxi or a chauffeur driven vehicle or have someone accompany you. This is for your own safety.
Hope this helps.
Let me know if you have more concerns about this.
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Customer: replied 2 years ago.

That gives me a partial answer for which thank you. But what about the Aspirin? I was not given it on the last (and far more serious) occasion and my understanding is that if anything Aspirin promotes bleeding - and was what Iexperienced really a TIA?

Expert:  Dr Uzair replied 2 years ago.
Aspirin can promote bleeding but TIA's are due to ischemic stroke as a result of emboli or a thrombotic event which means that it is due to blood clots rather than bleeding and aspirin helps with these by thinning the blood and preventing the blood clotting thereby decreasing the chances of having an ischemic stroke. Aspirin is contraindicated in the other type of stroke known as Hemorrhagic stroke. The previous event you had bleeding due to trauma in it and that is why aspirin was not given because it can worsen that condition. In the recent event the cause is the opposite, that is the blood clotting and sending off an embolus (like a missile) of blood clot occluding the blood vessel and causing ischemia of the area it supplies, aspirin prevents this.
Glad I could help.
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