Hemianopsia - Stroke? Migraine? or TIA?

[♥3oh!3Freak♥]

I awakened the other morning with a headache on the left side. The headache was focused only in the area as if someone had parted a section off (from the top of my head, as if I were parting my hair on the left side, down to the bottom part of my scalp above my left ear). Since I am a kidney transplant patient with high blood pressure, which is controlled through medications, it is rare for me to have a headache. In addition, I noticed that reading the news banners at the bottom of the TV screen were blurred, and I was having difficulty focusing. In addition, I was experiencing slight nausea (which I had for a day or two afterwards), which I attributed to the visual disturbances.

While driving to work is when I realized something was seriously wrong with my vision. I was heading south, and as the cars traveling north approached me, I could see the front part of the car but not the rest of the car.

I went on to the office but called my Opthomologist's office and arranged to go in at 11:30 that morning. While driving to my appointment, I noticed that I was only seeing the left half of a sign, whether it be a road sign with words, or a railroad crossing sign. The area that I could not see was not black or grayed out. If I had never, ever seen the road signs before, they appeared normal. It didn't appear as if anything was missing since the background color (i.e., railroad signs are yellow) remained the same, so what I saw was only the left side of the X and the R to the left of it. No letters or words were visible on the right side.

By the time I finished going through all sorts of tests at my Opthomologist's (about 5 pm) , my headache was gone and, although my vision was still blurry, the hemianopsia had resolved. There is one incident that occurred that day that stands out. After administering the first part of the peripheral vision test, the tech and I were chatting. My left eye was still covered with the patch and all of a sudden the room went dark. I remember remarking, "Oh, my God, everything has gone black." My first thought was that someone had turned the lights in the room off and, secondly, I thought I had gone blind. But as quickly as it happened, my vision returned.

I was referred to an imaging clinic for an MRI which was conducted on Friday, but the results won't be in until next week. So, if anyone has experienced the same symptoms, anything you can tell me is greatly appreciated. Was this entire episode a stroke, mini TIA, migraine, or what?

 

[esther m]

match3

I believe you should be calling your primary care physcian or the transplant surgeon to let them know of this event. They may want to do some additional testing. They will also most likely want a copy of the MRI Report. If this happens again and hopefully it will not, I would go immediately to the Emergency Room to let them determine if you are experiecing a stroke.

I hope you are feeling better

Brenda

 

[Paulo]

Brenda:

Thank you for your reply and suggestions.

Prior to setting an appointment for the MRI, I had the Opthomologist's assistant clear it with my Nephrologist, and then when I arrived at the imaging clinic for the MRI, they had to clear the test with my Nephrologist, as well as receive his clearance for me to have the dye injected for imaging since the kidneys have to filter the dye which is known to be hard on the kidneys. Since the transplanted kidney is of primary importance, I have a standing request with all of the specialists I see that my Nephrologist be copied with all test results, and physician notes.

I agree I probably should have gone straight to the ER, but I have been having some vision problems lately ... a vitreous hemorrhage, and then what I refer to as a "light show," which I understand can be a precursor to a retinal tear. To be quite honest, it wasn't until the Opthomologist indicated that since all the testing he did was negative and that it might be a neurological problem, that the thought "stroke," and "TIA," came to mind.

Hopefully, within the next day or so I'll have a more definitive answer and will post the results, if for no other reason than to help others who may experience the same symptoms.

Again, thank you. Your post was very beneficial and trust me, should I experience this again, I'll go straight to the ER.

 

[message_board_ceo]

match3

I am glad that you are feeling better. It sounds like you are a very well informed patient. It also sound like your Nephrologist is also a very good at in his profession. I always get copies of all of my reports because even though you have a standing order for copies to be sent to the appropriate doctors, some how these reports do not quite make it to the correct locations.

Please let me know when you get your MRI results.

Brenda

 

[yahoo critic]

Finally received the diagnosis. Since the MRI did not show anything current, my Opthomologist said it was an occular migraine. However, the MRI disclosed that I have a small, old infarct in the right caudate, which was news to me.

 

[Steven Murphy]

i was thinking classic migrane as you simply started to describe everything, with the being ONLY one sided, and esp with only the 'parts' of things like the cars actually 'being there" too? i have suffered with migrane with 'aura' since i was only 13(am 49 now)? and have had some of the most insane and off the wall types of pre migrane auras that do go from total complete blackness with one, and most of the rest my vision kinda looks like a picasso painting? or like looking into a broken mirror kind of effect with like everything i look at during this period being all broken apart and with insane flashing and jaggedy like lights in my visual field too? luckily, and hopefully you CAN take these types of "abortive" meds like the one that was the first to even hit the market back in 1981 and was an asbolute godsend to me back then called "midrin"? but check with your transplant co ordinator to be certain and your pharm too?

but is simply now take two of these pills at the onset of my aura and within 45 min i can actually drive a freaking car if i have to, where as before? i was down, just down in a dark room for at least 12 hours per migrane that back in my teens were slammin me 7-10 times a flippin month. at least they have identified the underlying problem now and there IS good solid types of abotive treatment for these now.

the one thing i wanteds to mention to you here about using contrast at all with your kidney tx? while i DO have my own kidney disease that has also impacted my liver as well, my youngest son went thru a insane liver failure and need for tx back when he was 13 so i am familiar with tx stuff here too? i was told by my neph when i was initially Dxed with PKD to always decline the contrast dye from here on out? i have a TON of spinal and brain issues that require me to keep having to get scans done that some like the angiograms i have had just HAVE TO use contrast for or they cannot obtain the needed clarity of pics? well i DID find out ONLY after i was going to need another angiogram to look at what was a confirmed aneurysm that there IS a med called mucomyst or acetylcystine? that actually allows anyone even those in renal failure to actually 'safely' use contrast dye? the muco actually is the tylenol OD antidote they use in ERs? but what this stuff does when used for a contrasted pic you are going to have(you just mix it with like OJ since it is a smelly like sulpher liquid)is it actually fully encapsulates that dye then safely allows this to be pushed thru your kidneys WITHOUT any of this actually being filtered BY your kidneys at all? i have had to use this soo many times and have never ever had issues with it asd far as it impacting my kidneys at all. and now of course my neph loves this stuff for me to use when needed too?

but this IS one possible option for you hon that incase you simply HAVE to even have any type of contrast used for any purpose, it can be used and not hurt your kidneys one bit. i WAS pretty stunned when i found out about this stuff myself, but it works extremely well as far as protecting kidneys from contrast goes? i have NEVER had any changes occur with my creatinine going up even slightly at all or my GFR going down 'only' because of needing contrast but also taking the muco the day before, the morning of and one dose after any contrasted procedure/scan.

but as with ANY meds, always, always check everything out with your transplant co ordinator which i automatically just have done and do for my son whenever he has needed any new meds. i am sure you know the drill by now, lol. they just do really KNOW sooo much and in most cases, you simply cannot ever seem to actually even track down a tx surgeon? always busy doing something. but muco really is a very safe med and pretty innocuous as far as actually interacting with other meds simply by virtue of what it is made up of and modes of action? but just something i thought you should actually know about since you have had to already undergo one MRI where contrast was needed but not used, or was it(was not actually really clear?) to obtain the very BEST possible pics of all the vascular structures esp within anyones brain?

hopefully they will allow you a good abortive if the migrane hits again. is there ANY family history of anyone actually having migrane at all? these are something that in most cases are actually inherited from usually a female? this was my case. it was on my dads side. but they CAN also just start up in a person for no apparent reason too? but having something you can safely take/abortive that does not intertact with your tx meds and is okay with the kidneys too is very important for you and for me too. i will be needing a kidney here much sooner vs later since things are progressing now with actual lab changes that were not happening before? this IS how polycystic kidney disease just 'is' and how it plays out in its insanity. massive amounts of huge cystic damage along with insane enlargemnt of the impacted organs too, but no real lab changes til towards the end? no possible treatment at all, you just get to wait for full renal failure, yippie. born with it but did not find out i even HAD any kidney or liver disease since all labs perfect actually up til just last year? it was only my sons sudden deathly illness with his liver occuring and the connection to having to have PKD to even have what he got hit with, is when i found out when i was already like 40?

i DO wish you luck with everything hon. what was the actual reason/condition for YOUR kidney transplant? what disease or issues caused your renal failure to even begin with? were you able to actually do a live donar or did you have to be placed on that dreaded 'list'? just that lil curious mind o mine. so glad everything worked out well for you hon. FB

 

[mobby]

Thanks for your reply, and with so much interesting and useful information.

What's interesting about my occular migraine is that outside of the headache that morning (which was not disabling), and the goofy vision problems (which scared the daylights out of me), everything was pretty much back to "normal" that evening except for the blurred vision from having my eyes dilated. No residual headache, and no headaches since. There is no history of migraines in our family that I am aware of.

It sounds as if you, too, have been through the mill, and to have a child with chronic health problems. My thoughts and prayers will be with you and your family.

My family's renal failure is genetic ... our mother passed away in 1967, at the age of 45, from glomerulonephritis. Diagnosed at the age of 43. Dialysis was on the horizon but was not readily available. Prior to her passing, she received frequent blood transfusions to cleanse her blood of the toxins. Pretty primitive in comparison to today's options. The disease was passed on to all 4 children, 3 girls and 1 boy. All of the girls (me being the youngest of the girls) have all been successful with transplantation. Our brother, who passed away at the age of 47 in 2006, had been on different modalities of dialysis for right at 30 years. He had 2 transplants, one in 1981, and the other in 1990. Although he was very compliant, his transplants failed. The first one lasted about 2 weeks before experiencing an acute rejection; the second lasted not quite a year. Through biopsies, my two older sisters were both diagnosed with glomerulonephritis, whereas my brother and I (the two youngest) were diagnosed with interstitial nephritis.

Transplantation is a wonderful gift ... all of ours were cadaveric transplants. Both of my sisters received 6 matches (perfect), the oldest sister kept her 6 match for about 11 years (she was almost, from the start, in a chronic rejection); but received a second transplant within the same year she rejected and is going on 9 years with her second one; my middle sister received her transplant in 1988, and it is such a "perfect" (6) match that she does not take any immunosuppresants. She does take prednisone, a steroid. I walked in the hospital on June 6, was transplanted on the 7th., went home on the 14th., and have never experienced a rejection episode. I just celebrated 20 years with a 3 match. Our brother's first transplant was a 5 match, and the second was a 2 match.

Again, thanks so much for sharing, and especially for educating me, and others who may read this post, on other options available when testing with dyes.