Fukuda H, Kitani M, Omodani H
Department of Neurology, Masuda Red Cross Hospital, Shimane, Japan.
Stroke. 1997 Jul;28(7):1461-3. doi: 10.1161/01.str.28.7.1461.
We report here a rare case of repeated syncopal episodes associated with smoking and findings of 99mTc-hexamethylpropyleneamine oxime (HMPAO) brain single-photon emission CT (SPECT) imaging.
A 77-year-old man had four syncopal episodes during a half-month period. All four occurred when he stood up and walked immediately after smoking a cigarette, and syncope did not occur after cessation of smoking. Although upright testing revealed orthostatic hypotension, the patient did not complain of fainting on standing alone. Compared with brain SPECT in the supine position, perfusion was decreased in the posterior circulation structures after the subject smoked a cigarette or chewed nicotine gum.
The combination of cerebral vasoconstriction due to smoking and orthostatic hypotension probably decreased cerebral blood flow in this patient, resulting in syncope.
我们在此报告一例罕见的与吸烟相关的反复晕厥发作病例以及99m锝-六甲基丙烯胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT）成像结果。
一名77岁男性在半个月内发生了四次晕厥发作。这四次发作均发生在他吸烟后立即起身行走时，戒烟后未再发生晕厥。尽管直立试验显示有体位性低血压，但患者单独站立时并未抱怨晕厥。与仰卧位脑SPECT相比，受试者吸烟或咀嚼尼古丁口香糖后，后循环结构的灌注减少。
吸烟引起的脑血管收缩与体位性低血压相结合，可能导致该患者脑血流量减少，从而引发晕厥。
