Is there a doctor or medical student in the house?

May 2, 2009 10:04 AM

Any doctors or medical students in the house?

My father had a CT head scan a few weeks ago. It was just a precaution because he's a little unsteady on his feet (he's 71). The letter from the specialist says there's nothing wrong apart from "an ill-defined area of low attenuation over the left parietal lobe likely representing a small ischaemic focus". The doctor advises aspirin.

What does this mean?

posted by deeper red to health & fitness (11 comments total)

Disclaimer: I am an undergraduate neurobiology student. I have no experience in medicine; I do, however, have some knowledge of medical terms, especially those associated with the brain.

Low attenuation = weakening in radiodensity in the CT scan. This is merely a description of the scan itself.

Ischemic focus = a term usually associated with stroke and other conditions where there are blood flow problems in the brain. There is probably a portion of your father's brain that is getting decreased blood flow.
posted by kldickson at 10:11 AM on May 2

Not snarky, I swear, but: why don't you call the doc and ask for a clear explanation?
posted by tristeza at 10:12 AM on May 2 [3 favorites]

IANAD, but it basically means there's a small part of you father's brain that isn't getting quite as much blood as it should. Ischemia is loss of blood flow usually from plaque buildup in the vessels. The doctor prescribed aspirin because of it's anti-platelet effect. It will allow blood to pass through the vessels more easily and keep them from becoming a clot which could lead to a TIA or a stroke.
posted by brevator at 10:12 AM on May 2

> Not snarky, I swear, but: why don't you call the doc and ask for a clear explanation?

Well, there's a couple of reasons.

First, the letter arrived this morning (Saturday). It's a bank holiday weekend here in the UK, so the earliest my father can see the doctor is Tuesday -- assuming he gets an appointment immediately. I guessed it might be related to the possibility of a stroke, and it's just been confirmed by those who gave constructive replies. So I've been able to remind my dad of the symptoms of a stroke, and a TIA (thanks brevator). We've agreed that if he gets any symptoms he'll call an ambulance. I don't think he will over the next few days, God willing, but forewarned is forearmed.

Secondly, it's always good to get additional perspectives. Maybe somebody's own father has had a similar scan result, and they can tell me what it meant for them. Alternatively, it's just good to hear what others have to say -- maybe I'll learn something that the doctor wouldn't say because of the formal doctor/patient relationship. The Internet is good at less formal advice like this.

Do I get a couple of favorites for this reply, just like your question has?
posted by deeper red at 10:38 AM on May 2 [12 favorites]

Yeah, what kldickson and brevator said.

Not snarky, I swear, but: why don't you call the doc and ask for a clear explanation?

My guess would be A) it's Saturday and the doc is likely not available, B) even if it were a weekday, it may be hours/days before the doc is available, C) patient privacy regulations (HIPPA) may prevent the doc from discussing the poster's father's results anyway, and D) the poster was able to get two excellent answers within 8 minutes of posting the question on MeFi.

Not snarky? Really? It's not like the poster was asking for a diagnosis or prognosis. Looks like he/she just needed clarification of some complicated medical speak. Geez.
posted by ourroute at 10:38 AM on May 2 [2 favorites]

I apologize - I just thought that for a medical situation this serious, hearing the exact diagnosis/explanation from the doctor who's involved would be more helpful than info from Internet strangers. But I sincerely apologize, I was not trying to be an ass.
posted by tristeza at 10:44 AM on May 2 [3 favorites]

I am a neurology resident. What the report means is that your father probably had a small stroke. In context, it probably didn't do much and he may never have noticed having it--but he had a stroke, putting him at some increased risk of future strokes. Which is why the aspirin, which is shown to reduce the risk of having future strokes.
posted by adoarns at 12:39 PM on May 2

(I'm an internist & geriatrician.) FYI, many 71 yr olds' CT scans have this without a known stroke event. It's nearly universal by age 80. By age 70, almost everyone should be taking an aspirin daily (81 mg "baby" aspirin is probably enough). And keep the BP controlled. The majority of Americans over 40 have high blood pressure, which is a more imporant risk factor than cholesterol.
posted by neuron at 1:47 PM on May 2 [1 favorite]

Family doctor here. What adoarns and neuron said. This kind of thing shows up all the time and by itself doesn't have a whole lot of significance at age 71. Without knowing any specifics of the report or his clinical picture, most of the time we see this we don't wind up chasing it down or doing any other more aggressive intervention beyond the standard BP and cholesterol monitoring. Aspirin is a very reasonable, benign recommendation. An ACE inhibitor and/or a statin might make sense depending on your father's risk factors as well as his/his doctor's inclination.

That having been said, his doctor should explain all of this to him (and you) to your satisfaction.
posted by Slarty Bartfast at 5:09 PM on May 2 [1 favorite]

Thanks all.
posted by deeper red at 7:30 AM on May 6

FWIW he's now been to the doctor and pretty much everything said here applies. The doctor suggested he'd had a stroke without being aware of it, and has put him on aspirin. The doctor is also considering putting him on cholesterol medication, and is also considering referring him to a stroke clinic (although we suspect this is unnecessary because my dad feels fine).
posted by deeper red at 7:33 AM on May 6