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I am a 25 yr old female who has been having episodes of

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syncope and brain fog for...
I am a 25 yr old female who has been having episodes of syncope and brain fog for the last two some years I currently just got insurance and had a ct done at my local hospital due to trauma from having another episode in the shower and breaking my toilet with my face. My ct scan reads
Nonspecific low attenuation is noted in the white matter bilaterally, consistent with
age-related small vessel ischemic changes.
The sulci and ventricles are prominent but are in keeping with the patient's stated age.
Vascular calcifications are seen at the base of skull.
My local hospital pretty much said I was stable enough to go home but I needed to see a cardiologist and neurologist. I was also told my ekg was borderline and I had a incomplete right bundle branch block.
I’ve been very exhausted and having brain fog, nausea and overall feel like complete crap. I currently just spoke to another dr who asked if I had anxiety which I do not believe that is the case I have a very happy loving family I have a great job I have no reason to be anxious or stressed about anything other than my passing out episodes. Please if you could give any advice I would appreciate it. I have a eeg coming up and a appointment with. Neurologist in June
Thank you
Amy
Submitted: 3 months ago.Category: Health
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Answered in 2 minutes by:
4/1/2018
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 3 months ago
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 38,715
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 3 months ago

Hello Amy,

Apart from consulting neurologist and cardiologist, you would need further evaluation.

You should be evaluated for the following which are the commonest cause for sudden fall or syncope;

1) bradyarrhythmias; this is sudden slowing of the heart. it is mainly due to sinus and atrial node dysfunctions. Sick sinus syndrome is a prototype of these arrhythmias and is a major cause for syncope. 24 hour Holter monitoring, echocardiography etc are the investigations done for it.

2) neurocardiogenic mechanisms; this is fall of the blood pressure suddenly due to a sudden sympathetic failure (failure of the autonomic nervous system).

3) carotid hypersensitivity syndrome is an exaggerated response to carotid sinus stimulation. In some studies almost 50% cognitively normal people who had experienced non accidental fall were diagnosed with carotid hypersensitivity.

4) orthostatic hypotension is due to failure of autonomic nervous system and related heart regulatory mechanisms.

These are the more frequent causes of syncope.

Following further investigations need to be pursued in your case;

1) MRI with gadolinium contrast

2) Magnetic resonance angiography (MRA)

3) Tilt table test

4) Carotid sinus massage

5) Electroencephalography (EEG)

6) Stress cardiac test

7) Total creatine kinase (CK) and heart enzymes; done immediately after the fainting episode and would tell about the abnormal brain or heart activity which caused the fainting.

8) Following also may be done after the fainting episode; blood electrolytes and blood glucose.

These should be able to zero down the cause.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 3 months ago
I’ve done the heart monitor and the tilt table and I failed both apparently due to low blood pressure is what I was told. My brain fog and face tingle is still undiscovered I was wondering if you could interpret my ct scan of brain in a way that I can possibly understand
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 3 months ago

Your CT scan is not showing anything substantial which may be responsible for the syncope. You may need an MRI which is slightly better imaging modality.

Following is understood or can be interpreted by the CT;

1) Nonspecific low attenuation is noted in the white matter bilaterally, consistent with
age-related small vessel ischemic changes.

The tiny blood vessels of brain has decreased blood supply but corroborates with your age. This may thus is not clinically significant.
2) The sulci and ventricles are prominent but are in keeping with the patient's stated age.

The sulci are grooves in the brain, Ventricles carry cerebrospinal fluid of brain. These are slightly bigger but is in the normal range.
3) Vascular calcifications are seen at the base of skull. Blood vessel may contain more calcium than the normal.

This may be considered as a risk factor for old age brain diseases like stroke or dementia but presently does not point to a disease.

It is privilege assisting you.

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Customer reply replied 3 months ago
does that mean that my results are normal and I’m okay to wait until June to see a neurologist
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 3 months ago

These results are not significantly abnormal, thus will require further work up. A normal CT means, you need further investigations as it has not detected the problem.

Your problem is significant and instead of waiting till June, it should be investigated as early as possible.

Wishing you a speedy resolution.

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