Q: Two nights ago at 3 a.m., I awoke with what looked like a black set of lines in a spider web configuration on a dark field in front of my eyes. I saw it with my eyes both open and closed, but it was hard to make out. As far as I know, I have never had this happen before. The vision did not move, so it was unlike my scintillating scotoma. However, half an hour later, a headache began. I often awaken with headaches but never noticed scotomas in the night, so I am not sure this was one. What do you think? —Jane A.
A: While possibly related to migraine, visual disturbances like you describe could be a result of transient ischemic events, also known as mini strokes. These attacks trigger symptoms similar to stroke, but they only last a few minutes. Although they cause no permanent damage, they can be a warning of other problems. You should consult your physician as soon as possible for further evaluation and treatment.
Frederick Freitag, DO, Baylor Health Care System, Dallas
