title: Postprandial Hypotension and Coma Following Subarachnoid Hemorrhage in a Patient with Parkinson's Disease.
abstract: A 79-year-old woman with a history of Parkinson's disease was admitted to our hospital because of a subarachnoid hemorrhage. She underwent clipping the next day. On postoperative days 7-9, she exhibited hypotension and disturbance of consciousness after each meal. The administration of midodrine relieved the hypotension, and postprandial coma was no longer observed. In this case, the autonomic dysfunction in Parkinson's disease and impairment of cerebral autoregulation during cerebral vasospasm may have been involved in the postprandial hypotension (PPH) and coma. PPH occurs not only in patients with Parkinson's disease but also in elderly patients, particularly those with diabetes or hypertension. Therefore, PPH must be considered in the management of cerebral vasospasm following subarachnoid hemorrhage.
authors.affiliation: Department of Neurosurgery, Akita Red Cross Hospital, Akita, Japan. Electronic address: watanabejun1003@yahoo.co.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.affiliation: Department of Neurosurgery, Akita Red Cross Hospital, Akita, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Maruya
authors.affiliation: Department of Neurology, Akita Red Cross Hospital, Akita, Japan.
authors.forename: Kenjyu
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Neurosurgery, Akita Red Cross Hospital, Akita, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nishimaki
mesh_terms: D000368:Aged; D003128:Coma / Q000209:etiology*; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D013345:Subarachnoid Hemorrhage / Q000150:complications*
keywords: Parkinson's disease; Postprandial hypotension; cerebral vasospasm; midodrine; subarachnoid hemorrhage