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Thirteen patients presented with brief, repetitive, stereotyped transient ischemic attacks, large artery atherostenoses or occlusions with impaired collateral flow to a cortical perfusion borderzone, and orthostatic hypotension (OH). OH was caused by diabetes mellitus, aging, and treatments for ischemic heart disease and hypertension. Medical management of OH often eliminated the need for stroke prevention measures such as surgery or anticoagulation. Focal cerebral hypoperfusion from the combination of occlusive vascular disease and OH may be an underreported, treatable cause of TIA and stroke.
Bruce H. Dobkin (Sun,) studied this question.