Assault at the supermarket ended in a transient ischemic attack

For Natalya Zacharov, 47, from Hadera, it was supposed to be just another standard workday at the supermarket. One morning, she noticed a customer who put a few beverage cans into her purse and walked out of the supermarket without paying. While she was trying to stop her, the woman began pulling Natalya’s hair hard, while hitting her in the face and neck. After the incident, Natalya got a headache, but did not think it was anything important. Three days later, the headache got worse, and she began feeling dizzy, nauseous, having problems speaking, a lack of sensation on her right side, her vision became blurred, and she was rushed from her workplace to the Emergency Room at Hillel Yaffe. The series of tests she underwent confirmed the doctors’ suspicion that she had experienced a transient ischemic attack due to cervical artery dissection - a tear in the wall of one of the arteries in the neck, which is one of the most common reasons for strokes in young people.

“The imaging tests Natalya underwent demonstrated that she has a rare disorder called eagle syndrome, which only 4% of the population develops. In fact, it relates to a small, pointy bone just below the ear, which in this population is longer than normal. In most cases, people are unaware of the syndrome until they are diagnosed after trauma or the appearance of symptoms such as headaches and neck pain, blurred vision, discomfort in the throat and more, which are caused by prolonged and unnatural position of the neck. In Natalya's case, the CT scans showed that she has this syndrome and due to the injuries she received, she experienced dissection. In fact, the elongated bone injured the main artery in her neck and as a result of the injury, it applied pressure to it and caused the artery to narrow. This was expressed in her headache and pain in the neck, transient speech issues, transient weakness on one side, all characteristics of a transient ischemic attack (TIA),” explained Director of the Stroke Unit in the Neurology Department at HYMC, Dr. Sergio Shabtai.

Natalya being examined in Hillel Yaffe Medical Center's Neurology Department before being discharged

Dr. Shabtai further noted that among the population with eagle syndrome, approximately 20% may develop dissection. Luckily for Natalya, it was a TIA that was identified and treated in time. The conclusion is that we need to be aware in situations like these. After experiencing trauma, there may be neurological changes that can lead to a speech disorder, asymmetry, weakness on the side, vision disturbance and instability. Had Natalya not come into the hospital, the dissection could have progressed to complete obstruction of the artery. In this type of situation, the brain does not receive enough blood and the result could be a significant stroke, with catastrophic and irreversible implications, like full paralysis on the right side, speech disorders, etc.

“The common treatment in cases such as these is medication and, if the dissection worsens or the neurological symptoms progress, a stent may be implanted to open the artery and prevent blockage. Later, it is advisable to contact an ear-Nose-Throat (ENT) or an oral and maxillofacial specialist to consider surgery to shorten the long bone so that it does not reach the cervical arteries. This can prevent recurrent injury to the artery in the future,” said Dr. Shabtai.

Natalya was hospitalized for continued care and monitoring in Hillel Yaffe’s Neurology Department. The MRI ruled out ischemic brain damage. She received medication therapy and was discharged home a few days later.