Transient ischaemic attacks related to carotid stenosis precipitated by straining, bending, and sneezing
M J G Harrison
Middlesex
Hospital, Mortimer Street, London W1N 8AA, UK
Accepted 20 October
1998
Three patients are described in whom one or more carotid
territory transient ischaemic attacks (TIAs) were preceded by sneezing, straining, or bending over. It is argued that the mechanism involved dislodgment of embolic material from the site of carotid atheroma. This
mechanism should be considered as an alternative to paradoxical embolism when TIAs are precipitated by such physiological manoeuvres. Furthermore, TIAs should be added to the list of medical hazards associated with such events.
Keywords: transient ischaemic attacks; carotid stenosis; sneezing; straining
© 1999 by The Fellowship of Postgraduate Medicine
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