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February 8, 1964


JAMA. 1964;187(6):450. doi:10.1001/jama.1964.03060190066017

Transient focal cerebral ischemic attacks often occur in the presence of cerebral and extracerebral vascular lesions. Treatment of these attacks is considered in the editorial by Mackey which appears in the next column. It is not known how this intermittent local ischemia is produced, but it has often been suggested that systemic hypotension may be the responsible factor. However, since attempts to reproduce cerebral ischemicattacks in man by inducing hypotension have been unsuccessful, Kendell and Marshall stress that the role of temporary falls in systemic blood pressure in the production of such episodes should be more closely examined.1 These investigators used intravenous hexamethonium and a pivoted bed to induce hypotension in 37 patients with transient focal cerebral ischemic attacks. Administration of the drug was controlled so that a steady fall in blood pressure was achieved. Evaluation of the patients during the treatment period included assessment of speech, visual acuity,

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