Postprandial Hypotension and Coma Following Subarachnoid Hemorrhage in a Patient with Parkinson's Disease

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• 作者：Jun Watanabe ; MD^* ; ^{watanabejun1003@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Jun Maruya ; MD^* ; Kenjyu Hara ; MD^&dagger ; ; Keiichi Nishimaki ; MD^*
• 关键词：Postprandial hypotension ; subarachnoid hemorrhage ; Parkinson's disease ; cerebral vasospasm ; midodrine
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：25
• 期：4
• 页码：e58-e61
• 全文大小：453 K

文摘

A 79-year-old woman with a history of Parkinson's disease was admitted to our hospital because of a subarachnoid hemorrhage. She underwent clipping the next day. On postoperative days 7-9, she exhibited hypotension and disturbance of consciousness after each meal. The administration of midodrine relieved the hypotension, and postprandial coma was no longer observed. In this case, the autonomic dysfunction in Parkinson's disease and impairment of cerebral autoregulation during cerebral vasospasm may have been involved in the postprandial hypotension (PPH) and coma. PPH occurs not only in patients with Parkinson's disease but also in elderly patients, particularly those with diabetes or hypertension. Therefore, PPH must be considered in the management of cerebral vasospasm following subarachnoid hemorrhage.