|
|
|
|
|
Click Here to return To Results
|
|
|
|
We describe a 63-year old man with severe bilateral internal carotid artery disease who presented with repeated,brief attacks of left limb shaking precipitated by his standing up.Cerebral blood flow measured by xenon-133 inhalation showed reduced resting flows and a focal perfusion deficit in the right dorsofrontal and upper rolandic regions.Blood flow velocity and pulsatility index of the right middle cerebral artery measured by transcranial Doppler ultrasonography were also reduced.With hypercapnic challenge,both hemispheric tissue perfusion and blood flow velocity showed impaired reactivity.With induced hypotension,the focal perfusion deficit in the right dorsofrontal region was accentuated. Following right internal carotid endarterectomy,resting cerebral blood flow and blood flow velocity improved,as did hypercapnic vasoreactivity. These reversible deficits in cerebral blood flow and vasoregulation,which were maximal in the dorsofrontal region,are consistent with low perfusion in the border zone territory or the distal fields and demonstrate that hemodynamic failure is the likely mechanism for limb-shaking transient ischemic attacks from severe carotid artery disease. |
|
(click to filter results - removes previous filter)
carotid artery disease
carotid artery stenosis
cerebral blood flow
cerebral ischemia
endarterectomy,carotid
limb shaking
orthostatic hypotension
shaking
transient ischemic attack
tremor,leg
tremor,orthostatic
|
Click Here to return To Results
|
|