[A case of hemodynamic brain infarction with postprandial hypotension].
A 76-year-old man with left internal carotid artery occlusion developed a progressing right hemiparesis. Brain MRI presented reinfarctions in the left anterior border zone and terminal zone in the left deep white matter. Ambulatory blood pressure monitoring showed a decrease in systolic blood pressure by more than 20 mmHg one hour after starting meals, which is considered as postprandial hypotension. The recurrent stroke occurred probably by a hemodynamic mechanism with the presence of internal carotid artery occlusion and postprandial hypotension. Administration of voglibose, an alpha-glucosidase inhibitor, improved postprandial hypotension. In patients with severe carotid or intracranial artery disease, the postprandial hypotension should be carefully monitored for prevention of hemodynamic brain ischemia.
Isa
Katusnori
K
Third Department of Internal Medicine, School of Medicine, University of the Ryukyus.
Tokashiki
Takashi
T
Tana
Takeshi
T
Muratani
Hiromi
H
Oya
Yusuke
Y
Takishita
Shuichi
S
D000368:Aged; D002341:Carotid Artery Thrombosis / Q000150:complications; D002544:Cerebral Infarction / Q000209:etiology*; D004435:Eating; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D012008:Recurrence