Introduction: Postprandial hemodynamic disturbances have been previously described. We report a case of postprandial transient ischemic attacks.
Materials and methods: Brain magnetic resonance imaging (MRI) (fluid-attenuated inversion recovery sequences, apparent diffusion coefficient), MR angiography, and Tc-99m hexamethylpropylene amine oxime single photon emission computed tomography-CT before and after acetazolamide challenge were performed in a patient with recurrent spells of hemiplegia following fatty meals.
Results: No recent infarction was observed on apparent diffusion coefficient maps. MR angiography showed occlusion of the left internal carotid artery and severe atherosclerosis of the cervical arteries. Tc-99m hexamethylpropylene amine oxime single photon emission computed tomography demonstrated hypoperfusion in the left middle cerebral artery territory at baseline and absence of cerebrovascular reactivity.
Discussion and conclusion: This case report supports the hypothesis of a modulation of the cerebral blood flow by fatty acids and highlights the potential impact of dietetic education in patients with impaired cerebrovascular reactivity.