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Updated: Feb 1, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebrovascular steal phenomenon in a patient undergoing dipyridamole nuclear perfusion cardiac imaging
Manjunath Raju1, Girish Mood2, Heather Laird-Fick1
1Department of Medicine, Michigan State University, B-301 Clinical Center, East Lansing, MI 48824, USA.
Abstract:
Transient ischemic neurological deficits following intravenous dipyridamole administration during pharmacological cardiac stress test are seldom reported, but there can be serious vascular complications. We report a case of a 58-year-old Caucasian male who developed expressive aphasia after dipyridamole infusion during an elective dipyridamole-technetium cardiac stress test performed for chest pain. Computed tomography angiogram of the neck revealed a known total occlusion of the right internal carotid artery and 50% stenosis of the left internal carotid artery. The patient's aphasia spontaneously resolved within 24 h. In this paper, we report a unique case in which the administration of intravenous dipyridamole precipitated transient ischemic attack in a patient with stable asymptomatic bilateral carotid artery disease and prior carotid endarterectomy. We also discuss the intracerebral vascular steal phenomenon as a possible pathophysiological mechanism in this patient.
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