[A case of transient ischemic attacks preceded by postprandial hypotension].

A 78-year-old man with a history of total gastrectomy, myocardial infarction and hypertension was admitted to our hospital because of frequent transient attacks of consciousness disturbance, aphasia and right hemiparesis after meals. His attacks occurred one to three times a day, 30 to 60 minutes after meals and lasted 120 to 180 minutes. At the time of the attacks his blood pressure decreased, but his pulse rate did not change. Cerebral angiography demonstrated atherosclerotic occlusion of the left internal carotid artery. There was no myocardial uptake of 123I-metaiodobenzylguanidine (MIBG). These results suggest that our patient had an autonomic dysfunction. Duplex carotid ultrasonography revealed that the blood flow velocity fell about 30% at the time of the attacks. His autonomic dysfunction and major artery occlusion may have produced a hemodynamic TIA following postprandial hypotension.