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Orthostatic hypotension in acute cerebellar infarction

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Author(s)
Hyung LeeHyun-Ah Kim
Keimyung Author(s)
Kim, Hyun AhLee, Hyung
Department
Dept. of Neurology (신경과학)
Brain Research Institute (뇌연구소)
Journal Title
Journal of Neurology
Issued Date
2016
Volume
263
Issue
1
Keyword
Orthostatic hypotensionCerebellar infactionHead-up tilt test
Abstract
To investigate the frequency and pattern of orthostatic hypotension (OH) associated with acute isolated cerebellar infarction, and to identify the cerebellar structure(s) potentially responsible for OH, 29 patients (mean age 60.0) with acute isolated cerebellar infarction performed a standard battery of autonomic function tests including the head up tilt test using Finapres for recording of the beat-to-beat BP response during the acute period. Cerebellar infarction related OH was defined as fall in BP (>20 mmHg systolic BP) on tilting in patients without any disease(s) that could potentially cause autonomic dysfunction, or in patients who had a potential cause of autonomic dysfunction, but showed the absence of OH during a follow-up test. The severity and distribution of autonomic dysfunction were measured by the composite autonomic severity score (CASS). Nine patients (31 %) had OH (range 24-53 mmHg) on tilting during the acute period. Most patients (7/9) had a remarkable decrement in systolic BP immediately upon tilting, but OH rapidly normalized. Mean of maximal decrease in systolic BP during head up tilt test was 37.0 mmHg. The OH group showed mild autonomic dysfunctions (CASS, 3.7) with adrenergic sympathetic dysfunction appearing as the most common abnormality. Lesion subtraction analyses revealed that damage to the medial part of the superior semilunar lobule (Crus I) and tonsil was more frequent in OH group compared to non-OH group. Cerebellar infarction may cause a brief episode of OH. The medial part of the superior semilunar lobule and tonsil may participate in regulating the early BP response during orthostasis.
Keimyung Author(s)(Kor)
김현아
이형
Publisher
School of Medicine
Citation
Hyung Lee and Hyun-Ah Kim. (2016). Orthostatic hypotension in acute cerebellar infarction. Journal of Neurology, 263(1), 120–126. doi: 10.1007/s00415-015-7945-7
Type
Article
ISSN
0340-5354
Source
http://lps3.link.springer.com.proxy.dsmc.or.kr/article/10.1007%2Fs00415-015-7945-7
DOI
10.1007/s00415-015-7945-7
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33251
Appears in Collections:
3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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