[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.
Third Department of Internal Medicine, School of Medicine, University of the Ryukyus.
Katusnori
K
Isa
Takashi
T
Tokashiki
Takeshi
T
Tana
Hiromi
H
Muratani
Yusuke
Y
Oya
Shuichi
S
Takishita
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