Abstract
The patient was 47 years old on his first visit in 1969 and has been treated at our outpatient clinic until now, at the age of 79. The initial blood pressure was 164/98mmHg without abnormalities on electrocardiogram or urinalysis. He was followed-up for 8 years with non-pharmacologic treatment, which was eventually changed to antihypertensive drug treatment. At the age of 71 he was admitted because blood pressure increased to 210/110mmHg, with marked fluctuation. At admission bilateral ocular (right<left) and carotid bruits (right<left) were detected. At the age of 75 he had cerebellar infarction with reversible neuro-logic deficits. At the age of 76 he was again adimitted because the labile hypertension was difficult to control. Cerebral angiography which was performedto clarify the relationship between labile hypertension and cerebral ischemia revealed significant bilateral stenosis at the portion of the cavernous sinus inthe internal carotid arteries. The stenosis was more remarkable on the left side than the right side. Based on the angiographic findings we considered the ocular bruits to be not a murmur of augmentation flow but a stenotic murmur.
