FEMALE PATIENT WITH TRANSIENT ISCHEMIC ATTACKS AND HIGH-GRADE STENOSISOF THE RIGHT INTERNAL CAROTID ARTERY. HOW TO PREVENT ISCHEMIC STROKE?CLINICAL CASE

Abstract

Transient ischemic attack (TIA) represents a critical neurological emergency characterized by acute focal neurologic deficits due to transient brain, spinal cord, or retinal ischemia, without resulting in tissue damage. The evolution of diagnostic imaging and therapeutic interventions has reshaped the understanding of TIA, emphasizing the presence of tissue damage as a pivotal factor. Differentiating TIA from mimicking conditions is crucial for prompt evaluation and risk reduction. Case report: We present a case of a 62-year-old female with recurrent TIA symptoms, including speech disturbance, facial dropping, tongue numbness, and left limb weakness. Despite prior outpatient consultations and imaging showing no evidence of ischemic foci, subsequent episodes led to persistent left arm weakness. On admission to the Neurology CT brain angiography revealed acute ischemic stroke in the territory of the right middle cerebral artery with high-grade stenosis of the right internal carotid artery. The patient underwent successful stent placement in the right internal carotid artery with subsequent dual antiplatelet therapy. Motor rehabilitation and repetitive transcranial magnetic stimulation (rTMS) resulted in significant motor improvement within days. Conclusion: Timely evaluation, accurate diagnosis, and immediate intervention are imperative in managing TIA and preventing ischemic stroke. Collaboration between neurology and invasive cardiology departments facilitates optimal patient care, emphasizing the importance of modern diagnostic and therapeutic approaches in acute cerebral ischemia.