title: [A case of transient ischemic attack of hemodynamic origin induced by postprandial hypotension].
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus Graduate School of Medicine.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Sakima
authors.forename: Katsunori
authors.initials: K
authors.lastname: Isa
authors.forename: Koh
authors.initials: K
authors.lastname: Nakachi
authors.forename: Kanako
authors.initials: K
authors.lastname: Shiroma
authors.forename: Takashi
authors.initials: T
authors.lastname: Tokashiki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications*; D004435:Eating; D006801:Humans; D007022:Hypotension / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male