Postprandial recurrent hemiplegia.
BACKGROUND
Postprandial hemodynamic disturbances have been previously described. We report a case of postprandial transient ischemic attacks.


METHODS
Brain magnetic resonance imaging (MRI) (fluid-attenuated inversion recovery sequences, apparent diffusion coefficient), MR angiography, and Tc-99m hexamethylpropylene amine oxime single photon emission computed tomography-CT before and after acetazolamide challenge were performed in a patient with recurrent spells of hemiplegia following fatty meals.


RESULTS
No recent infarction was observed on apparent diffusion coefficient maps. MR angiography showed occlusion of the left internal carotid artery and severe atherosclerosis of the cervical arteries. Tc-99m hexamethylpropylene amine oxime single photon emission computed tomography demonstrated hypoperfusion in the left middle cerebral artery territory at baseline and absence of cerebrovascular reactivity.


CONCLUSIONS
This case report supports the hypothesis of a modulation of the cerebral blood flow by fatty acids and highlights the potential impact of dietetic education in patients with impaired cerebrovascular reactivity.
Farid
Karim
K
Department of Nuclear medicine, CHU de Bordeaux, Bordeaux, France. kwfarid@hotmail.com
Renou
Pauline
P
Laffite
Marianne
M
Couffinhal
Thierry
T
Allard
Michèle
M
Fernandez
Philippe
P
Sibon
Igor
I
D006429:Hemiplegia / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007511:Ischemia / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012008:Recurrence; D015899:Tomography, Emission-Computed, Single-Photon