好色先生

好色先生

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Abstract Details

A Case of Limb Shaking Transient Ischemic Attacks Associated with Middle Cerebral Artery Stenosis and Functional Aortic Stenosis
Cerebrovascular Disease and Interventional Neurology
P04 - (-)
062
BACKGROUND: Limb shaking TIAs are an infrequent phenomenon described in carotid occlusive disease and are caused by cerebral hypoperfusion. They are characterized by involuntary shaking of the limbs, often precipitated by postural changes and orthostasis. They have also been reported with atherosclerotic occlusive disease of other intracranial vessels. To our knowledge, this is the first report in a patient with MCA stenosis and a functional aortic stenosis.
DESIGN/METHODS: A 77 year old lady, with a history of AVR on Warfarin, prior stroke, stable thoracic aortic aneurysm, presented with a 3 week history of episodic left upper and lower limb shaking on standing and walking. She had multiple episodes a day, lasting up to a minute, with dysarthria, left sided numbness and bilateral blurring of vision. She also had intermittent palpitations, shortness of breath, and chest pain. Her neurological exam was non focal. CT angiogram of her head and neck showed a focal area of moderate stenosis of the right M1 segment without significant carotid stenosis. TTE and TEE findings on valvular function were inconclusive. Valvular fluoroscopic studies revealed only partial opening of one leaflet of the aortic valve and pannus formation around the valve ring.
RESULTS: After aortic valve replacement the patient's symptoms completely resolved. In this patient aortic valve dysfunction created a functional aortic stenosis and a low flow state causing hypoperfusion in the right MCA territory with postural changes.
CONCLUSIONS: Patients with limb shaking TIAs and atherosclerotic occlusive disease, should be evaluated for other risk factors that may worsen cerebral hypoperfusion. This includes thorough assessment of valvular function in patients with mechanical heart valves.
Authors/Disclosures

PRESENTER 		No disclosure on file
Sahar Zafar, MD Dr. Zafar has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Zafar has received research support from NIH. Dr. Zafar has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker for a lecture with Marinus.
No disclosure on file
No disclosure on file
Joseph S. Kass, MD, JD, FAAN (Baylor College of Medicine) Dr. Kass has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生 . Dr. Kass has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Kass has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple Law Firms . Dr. Kass has received publishing royalties from a publication relating to health care.
Roopali Gandhi, PhD (Sanofi Genzyme) No disclosure on file