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Age and Ageing 2005 34(1):86-88; doi:10.1093/ageing/afh241
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Age and Ageing Vol. 34 No. 1 © British Geriatrics Society 2005; all rights reserved

Case Report

Orthostatic hypotension following acute intracerebral haemorrhage

Lisa M. Capaldi1, Balaji Rangarajan2 and Roger A. Shinton1

1 Heartlands Hospital, Department of Elderly Medicine, Birmingham, UK
2 The University of Birmingham, School of Medicine, Birmingham, UK

Address correspondence to: L. M. Capaldi. Email: lisacapaldi{at}aol.com

Background: blood pressure regulation may be impaired following acute stroke. Typically, there is overactivity of the sympathetic nervous system and underactivity of the parasympathetic system resulting in transient hypertension. Orthostatic hypotensive responses in acute stroke are less well documented.

Case report: we present a case of severe persistent orthostatic hypotension (OH) following acute intracerebral haemorrhage in a previously fit and well man. Symptomatic OH persisted for 60 days post-stroke. No known causes of OH could be identified.

Conclusions: such profound and persistent orthostatic hypotension following an acute intracerebral haemorrhage has not previously been documented. The precise cause of this finding in the case described is unknown, but may have been due to impaired higher-level regulation of the autonomic nervous system. A conservative approach with prolonged physical methods proved successful in rehabilitating this patient without the need for pharmacological intervention.

Keywords: hypotension, orthostatic, stroke, physiotherapy, elderly

Received April 27, 2004; Revision received September 15, 2004. accepted in revised form September 15, 2004.


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