Cerebral blood flow dynamics of orthostatic transient ischemic attacks in a patient with carotid dissection and fibromuscular dysplasia.

In patients with critical carotid stenosis and ischemic stroke, it is crucial to determine whether distal hypoperfusion or artery-to-artery embolism is the predominant mechanism. The role of transcranial doppler (TCD) in this setting is vital. We report a patient with fibromuscular dysplasia and recurrent orthostatic transient ischemic attacks where fall in cerebral perfusion was clearly demonstrated by TCD.