Psychiatrist referral - is this usual? Ct scan outcome

Discussion in 'ARCHIVE FORUM: Support discussions' started by sheila d, Dec 21, 2007.

  1. sheila d

    sheila d Registered User

    Dec 8, 2007
    25
    liverpool
    It's 2 weeks since Mum went in to a hospital and today she was finally moved to the local assessmant and rehab unit. We had our 1st meeting with a doctor:mad:

    Firstly her CT scan is clear, but I asked about TIA's and was told that they don't show up on a CT scan - if that is correct, then how are they dignosed please ?

    Secondly, the mental health assessment team have asked for a referral to a psychiatrist. Can you tell me please, is this a normal step in trying to get a diagnosis and does it have any significance? The doctor made comment about her not being capabale of looking after her own welfare.

    Thirdly the doctor has said that she has no awareness of her own mental condition, just blames me for telling them that she has gone mad :eek:
     
  2. Kayla

    Kayla Registered User

    May 14, 2006
    621
    Kent
    My Mum had a home visit from a hospital doctor, after she had particularly bad hallucinations and he said that she definitely didn't have "senile dementia", because she was clean and tidy and was wearing matching clothes.

    The GP said she definitely hadn't had any strokes, despite Mum having all the classic symptoms of vascular dementia. The matron in the NH was the only person to explain Mum's condition properly to us and recognise the problems and treatment necessary.

    If Mum had been diagnosed at the beginning of her illness, we would have been able to deal with the situation in a better way and there would have been far less hassle.

    Thank you for the Talking Point Forum and I wish I'd discovered it much earlier, but we didn't even know that Mum had dementia to start with. I think the NHS and Social Workers let us all down.

    Kayla
     
  3. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    I think that most TIA's don't show up on any scans. By their very nature they are transient. To be honest it's never been clear to me how TIA's can cause dementia - I can only assume that the interrupted blood supply causes cells to die, but not so many that it shows on a scan. A lot of dementia diagnosis is to do with exclusion: scan doesn't show any damaged areas - so not a major stroke. Scan doesn't show plaques and tangles so not AD. Person is obviously suffering from dementia, and they have health issues that might cause vascular problems Q.E.D they must have vascular dementia. Having said that I think it's a good thing that she's been referred to a psychiatrist. They have considerably more expertise (general statement but that's been my experience) in the whole dementia field so you may get a diagnosis that you feel you can rely on. As to the lack of insight - I think that's almost a given when dementia gets to a certain stage.
     
  4. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Hi sheila, I think using a psychiatrist to help determine diagnosis of dementia is often down to LAs. Even within our county this varies from area to area.

    Lionel was diagnosed after MRI scan, SPECT scan and a visit to a Neuropsycologist. The last we had to pay for privately, as his consultant recommended it but the local PCT did not have a NH one. Bizarre really.

    Agree that TIAs do not show up on scans. Just hope that you get the help that you need soon. Please keep in touch.
     
  5. river_

    river_ Registered User

    Oct 15, 2007
    33
    UK
    I would agree that vascular or multi infarct dementia is diagnosed by signs, symptoms and medical conditions and history.

    People often say how a patient gets a little worse after each TIA, by definition it is a stroke they are having if the change happens for more than 24 hours.

    In most vascular dementia it is partial or total blocking of arteries supplying blood and nutrients to brain cells. Cells can survive a limited time but start to die after 3 mins without 02 and nutrients plus there may be a build up of toxins if flow is reduced thought the area.

    You might be able to think back to time when your loved one has been tired or vague (we can with my gran) and realise that was probably a TIA, although the vagueness seems to improve after these episodes a year down the line her dementia seems to have advanced.


    My gran has been seen by her local memory clinic run by a psychiatrist where they found evidence on scan of one stroke. With taking her Ss and Ss the dr agreed with mum that it was vascular dementia when mum asked.

    My gran has very poor insight into this and is adamant she is fine most of the time with the occasional "oh I dont know whats wrong with me". What does come more often is "I dont feel right today, I cant shake this feeling, I feel like I havent woken up properly and it's not good" poor spud :(

    Not all Drs are tactful or good with people, stick around here you'll be 'right *hugs*
     

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