Volume therapy in orthostatic transient ischemic attacks.
We report the case of an 83-year-old man with recurrent orthostatic transient ischemic attacks despite anticoagulation and crystalloid therapy. An initial cerebral angiogram revealed a nearly occluded right carotid artery with a string sign. Following aggressive volume expansion with albumin, the patient became asymptomatic. A second angiogram demonstrated the resolution of the carotid string sign and unmasked a high-grade, very tight, surgically approachable stenosis. The role of a high intravascular volume status is discussed.
Pascual-Leone
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A
Department of Neurology, University of Minnesota, Minneapolis.
Anderson
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DC
Larson
D A
DA
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D004691:Endarterectomy; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011187:Posture; D011859:Radiography
D010952:Plasma Substitutes