Thromboembolic Brain Infarction

Background and Purpose We investigated the changes of circadian blood pressure patterns after thromboembolic and hemodynamic brain infarction and evaluated the relation between circadian blood pressure variation, infarct location, and activation of the autonomic nervous system after thromboembolic stroke. Methods Repeated 24-hour blood pressure measurements were performed in 45 patients with proven first-ever brain infarctions of different origins. Evaluation of serum norepinephrine concentration, prolongation of the QT interval, and degree of cardiac arrhythmias were used to determine the extent of sympathetic activation after thromboembolic stroke. Results Whereas circadian blood pressure variation was significantly increased after hemodynamic infarction compared with a control group (diastolic, -752±A5% versus -13.8±6.5%; P<.005), a clearly reduced variation was observed after thromboembolic infarction (diastolic, —5.2±6.9%). Blood pressure variation was positively related to serum norepinephrine concen-