An 82-year-old man had a transient ischemic attack (TIA) with symptoms of consciousness disturbance and right hemiparesis while resting in a sitting position after breakfast. His symptoms improved around 1 h after onset when he lied in a supine position and received intravenous hydration. Duplex carotid ultrasonography revealed severe stenosis of the left common carotid artery. A decrease in the brain perfusion reserve was confirmed by acetazolamide-stress brain perfusion scintigraphy. Moreover, ambulatory blood pressure monitoring revealed a reduction in systolic blood pressure below 90 mmHg after each meal, indicating postprandial hypotension (PPH). The PPH was improved by oral administration of α-glucosidase inhibitor without any subsequent recurrences of TIA. The patient was diagnosed with TIA of hemodynamic origin that was induced by PPH and exhibited severe carotid stenosis. PPH is common in elderly people, and it should be recognized as a significant trigger for ischemic cerebrovascular disease.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5692/clinicalneurol.54.162 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cerebrovascular stenosis related to tyrosine kinase inhibitor for chronic myeloid leukemia: two illustrative cases.
BMC Neurol
January 2025
Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, 501-1194, Japan.
Background: Tyrosine kinase inhibitors (TKIs) improve prognosis in chronic myeloid leukemia (CML). Nilotinib and ponatinib, second- and third-generation TKIs, respectively, have been reported to cause adverse vascular occlusive events such as myocardial infarction and peripheral arterial disease. However, little is known about the risk of cerebral infarction associated with severe cerebrovascular stenosis, which is a late complication of TKIs.
View Article and Find Full Text PDFPrehospital video triage of suspected stroke patients in Greater Manchester: pilot project report.
BMJ Open Qual
January 2025
Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK.
Introduction: Stroke is a leading cause of mortality and morbidity, demanding prompt and accurate identification. However, prehospital diagnosis is challenging, with up to 50% of suspected strokes having other diagnoses. A prehospital video triage (PHVT) system was piloted in Greater Manchester to improve prehospital diagnostic accuracy and appropriate conveyance decisions.
View Article and Find Full Text PDFValidation and safety of AmbuLatory care for transient ischemic attack from emergency department (VALID study).
J Clin Neurosci
January 2025
CHU Clermont-Ferrand, Emergency Department, F-63000 Clermont-Ferrand, France; Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, F-63000, Clermont-Ferrand, France. Electronic address:
Background: Transient Ischemic Attacks (TIAs) are a common reason for Emergency Department (ED) visits and represent a significant public health issue. Patients experiencing TIAs often face significant delays in undergoing various tests due to ED overcrowding and limited availability of neurologists. Emergency physicians (EPs) and neurologists have identified several criteria for allowing outpatient management.
View Article and Find Full Text PDFBasic Science and Pathogenesis.
Alzheimers Dement
December 2024
Centre for Brain Research, Indian Institute of Science, Bengaluru, Karnataka, India.
Background: Vascular Dementia (VaD) is the second most prevalent cause of dementia, arising from the blockage of blood vessels in the brain. One event responsible for the blockage or narrowing of small blood vessels is transient ischemic attack (TIA), and these changes resolve within 24 hours in humans. The molecular mechanism underlying these changes in recovery in small vessels still needs to be investigated.
View Article and Find Full Text PDFCarotid endarterectomy and the risk of perioperative stroke: The importance of chronic ischaemic lesions and small vessel disease.
Eur J Neurol
January 2025
Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Background And Purpose: Perioperative stroke is a well-recognized complication of carotid endarterectomy (CEA), but well-performing prediction models do not exist for it. Our aim was to identify novel predictors for perioperative ischaemic cerebrovascular events (iCVEs), emphasizing cerebrovascular imaging and potential biomarkers for stroke in carotid stenosis (CS) patients in a well-characterized prospective CS cohort.
Methods: Helsinki Carotid Endarterectomy Study 2 is an observational prospective and consecutive cohort study of CS patients subjected to CEA during 2012-2015.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!