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Family Physician Response

Mr. C, do you have any experience with the term TIA? TIA means Transient Ischemic Attack. Basically this translates to a brief moment of changed function in the brain due to decreased blood flow. Once blood flow returns, brain function becomes normal again. In your case there was momentary reduced blood flow to one of the parts of your brain that involves speaking, but once blood flow came back you could talk normally again. Some of the tests they did in the emergency department were to confirm that what you had was a TIA, and that's what it looks like to me right now. The CT scan of your brain showed that there was no bleeding. The EKG results showed us that your heart was doing all right. They also did a blood test and found nothing abnormal like blood that was too thick.

I've just given you a lot of information. Do you have any questions? (Mr. C asks, "Why did they give me aspirin? I don't have a headache."). Aspirin decreases the stickiness of cells in the blood, so they won't clump together and form a clot. In patients like you who have had a TIA, aspirin can protect against forming a blood clot. You will only need to take one aspirin a day, because it has a long-lasting effect. Do you think you'll be able to do that? Now we are to going to do some more tests because we need to know just what caused the temporary blockage of blood flow in your brain. If the blockage happens again and stays around too long, it could cause permanent damage to your brain. (At this point I would ask Mr. C if he has any particular concerns. Most people would ask --"did I have a stroke?" I think it's better to let the patient raise this issue, but if he didn't I would say something like, "many people who have had a TIA are wondering if this was a stroke."). I can reassure you that you did not have a stroke. The TIA was a warning sign-- and we need to work together to take care of it, so that you won't have a stroke.

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Family Physician Note

You are giving this patient a lot of complicated and frightening information. Be sure to stop frequently and check-in with him to validate that he understands what you've said. You might ask him questions or ask him to summarize what you've just told him.