Abstract
Hemodynamic occurrence of cerebral ischemia is a recognized but poorly described entity. The aim of this study was to define the effect and hemodynamic significance of orthostatic hypotension and severe cerebral major artery stenosis as a cause of cerebral ischemia. The study group consisted of 161 patients admitted to our hospital from 1977 through 1995 with a clinical diagnosis of TIA or cerebral infarction that met the following requirement : that each patient was studied by cerebral arteriography and the upright tilt-table test. Twenty-three patients developed focal neurological signs in the standing position, and most of them had cerebral infarction with TIAs. Eighteen of the patients (78.3%) demonstrated orthostatic hypotension, and 2 of them developed focal neurological signs during the upright tilt-table test. Seventeen patients (73.9%) exhibited cerebral major artery stenosis of greater than 50%. Although stroke of orthostatic occurrence was related to orthostatic hypotension, transient hypotension that occurred immediately after standing was not related to patients with stroke of orthostatic occurrence, and continuous hypotension that occurred during standing was related to patients with stroke of orthostatic occurrence. Patients who had both orthostatic hypotension and severe cerebral major artery stenosis were related to stroke of orthostatic occurrence, but others who had either orthostatic hypotension or severe cerebral artery stenosis were not related to stroke of orthostatic occurrence. Patients who had both orthostatic hypotension and severe cerebral artery stenosis were related to stroke of orthostatic occurrence.
