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THE BRAIN.

transient ischemic attack (TIA) A temporary impairment of the brain caused by an insufficient supply of blood, which can result in brief memory or speech problems, weakness, paralysis, dizziness, or nausea. Episodes usually last for a few minutes, but they may occur for up to a few hours. An attack that lasts for more than 24 hours is considered to be a stroke.

unlike a stroke, which may have the same symptoms but involve a lasting deficit, TIA symptoms fade without permanent damage. However, they should be regarded as a possible forerunner of stroke and should be reported to a physician. Stroke does occur in from one-fourth to one-third of all patients with TIAs.

Causes

TIAs may be caused by a temporary block to an artery supplying the brain (embolism) or by a narrowed artery thick with fat deposits (atherosclerosis).

Symptoms

A wide variety of symptoms may occur, depending on the site of the block and how long the blood flow is impaired. symptoms may include weakness or numbness in legs or arms, disturbed speech (aphasia), dizziness, or partial blindness. A TIA is always followed by complete recovery.

Symptoms of TIA may be confused with a brain TUMOR or SUBDURAL HEMATOMA (blood-filled swelling); diagnosis may include brain scans and blood tests; ultrasound, angiography, or heart studies may be needed to pinpoint the problem.

Treatment

Because there is no way to tell whether symptoms are from a TIA or a stroke, patients should assume that all strokelike symptoms are an emergency and should not wait to see if they go away. A prompt evaluation within an hour can identify the cause of the TIA.

Depending on the diagnosis, the doctor may recommend drug therapy or surgery to reduce the risk of stroke in people who have had a TIA. The use of antiplatelet drugs like aspirin is a standard treatment for patients at risk for stroke. People with atrial fibrillation (irregular beating of the heart) may be prescribed anticoagulants.

traumatic brain injury The common general term for brain injuries that impair thinking as a result of physical trauma severe enough to cause loss of consciousness or damage to the brain structure. Each year, about 2 million Americans sustain a brain injury—about one every 15 seconds. More than a million brain injuries are sustained by children, 30,000 of whom will have permanent disabilities.

Males, especially those between the ages of 14 and 24, are twice as likely to be injured as females, followed by infants and then the elderly. children are more likely to incur traumatic brain injury during the spring and summer. Traffic accidents account for almost half of the injuries; about 34 percent occur at home and rest in recreation areas.

Traumatic brain injury includes both open and closed head injury. In an open head injury, the force of impact can cause scalp injuries and skull fractures, together with blood clots and bruising. This type of injury usually affects one place in the brain, producing specific problems. A closed head injury can cause more widespread damage, as the force of impact causes the brain to smash against the opposite side of the skull, tearing nerve fibers and blood vessels. This type of injury may affect the brain stem, causing physical, intellectual, emotional, and social problems. The entire personality of the person may be forever changed.

in young children, abuse is the primary cause of this type of injury; 64 percent of babies under age one who are physically abused have brain injuries, usually by shaking. in children under age five, half are related to falls. car and biking accidents and suicide attempts are the primary causes of traumatic brain injury in school-age children and adolescents.

Diagnosis

Some patients may experience coma after a brain injury; the degree of the coma severity is measured by the Glasgow Coma Score, which assigns a number to the degree to which patients can open their eyes, move, or speak. x rays and brain scans may help if a skull fracture is suspected.

Symptoms

The symptoms after a traumatic brain injury may be elusive, but it is important to understand that head injuries tend to get worse over time. obvious warning signs include

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