Postprandial cerebral infarction.

Area of Science:

• Neurology
• Cardiology
• Vascular Medicine

Background:

• Autonomic dysfunction, including postprandial hypotension (PPH), is linked to neurological disorders.
• PPH, characterized by symptoms like dizziness and light-headedness, can be overlooked but may lead to reduced cerebral perfusion.
• This reduction poses a risk for hemodynamic stroke or transient ischemic events, particularly in patients with chronic cerebral large vessel occlusion/stenosis.

Purpose of the Study:

• To investigate the association between cerebral blood flow and postprandial cerebral infarction.
• To highlight the importance of cerebral blood flow assessment in patients with cerebral large vessel disease.

Main Methods:

• Literature review identifying seven cases of postprandial cerebral infarction.
• Analysis of patient data regarding cerebral blood flow, collateral circulation, and vasoreactivity.

Main Results:

• Postprandial cerebral infarction occurred in patients with chronic cerebral large vessel occlusion/stenosis and reduced cerebral blood flow.
• One patient with poor collateral circulation and reduced vasoreactivity experienced recurrent events despite treatment, requiring bypass surgery.
• Non-pharmacotherapeutic and pharmacotherapeutic approaches can help manage PPH-related cerebral infarction.

Conclusions:

• Cerebral blood flow assessment is essential for stratifying patients at high risk of postprandial cerebral infarction.
• Physicians must consider PPH in patients with neurological disorders and cerebral large vessel disease.
• Long-term blood pressure monitoring and cerebral blood flow assessment are recommended for prevention.