Transient ischemic attack of the brain as the first link in a decompensatory event chain of cerebro- and cardiovascular incidents in a 68-year-old female patient with radiological features of Fahr’s syndrome – a case report

Abstract

Introduction: Transient ischemic attack (TIA) is a reversible episode of neurologic deficit, that symptomatically can be similar to stroke, but lasts shorter than 24 hours and does not cause any radiological changes in brain images. TIA is a major risk factor for subsequent ischemic stroke. Fahr’s syndrom is a rare, genetically conditioned incidence of calcified deposits in basal ganglia and cerebral cortex. Case report: A 68-year-old female patient was admitted to the Department of Neurology due to an incident of left limbs weakness and left mouth angle drop. The symptoms lasted 5 minutes. The initial brain CT revealed no acute ischemic foci, although the radiologist found characteristic features of Fahr’s syndrome. Carotid ultrasound showed stenosis of right internal carotid artery. The patient experienced an ischemic stroke in 6th day from initial symptoms. 4 days later a myocardial infarction occurred as well. Discussion: TIA is a major prognostic factor for an ischemic stroke with the greatest risk of incidence in the first week after initial symptoms. Proper imaging diagnostics and prophylactic treatment with aspirin and statins should be administered. Patients after TIA incident should stay under watchful neurological supervision during the first 3 months after the attack.