<s>[INST] My mom was diagnosed with carotid arterial stenosis 3 yrs ago after having a stroke and many mini strokes. In the past few months she has felt tingling in her face and inside her mouth as a precursor before she becomes very dizzy and unbalanced. It would usually resolve itself within 20 minutes. In the past week or so these episdoes have been occurring daily and sometimes don t resolve for hours. now for the last 3 days she has had nosebleeds that last 20 minutes or longer along with the dizziness. She is also unable to bend over, walk more than across a room or lift anything over her head without almost passing out. I think she needs to go to the er to get checked out She is adamant that doctors cant do anything to help and she doesn t have health insurance so she just wants to let things play out. Am I right to be concerned? [/INST] you're absolutely right. She is having frequent episodes of Ties which are warning signs of future major stroke. As u told she also has carotid stenosis, if it is severe then carotid angioplasty and Stenton can be done. Nose bleeding is different issue. It is not related with carotid stenosis.  Most of the time if it is due to local nasal cause. For this consult an ENT specialist. Also check her BP during episodes of nasal bleeding as rarely high BP nay cause epistaxis. </s>