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Brain, Vol. 106, No. 2, 419-434, 1983
© 1983 Oxford University Press

research-article

CRITICAL PERFUSION OF BRAIN AND RETINA

R. W. ROSS RUSSELL and N. G. R. PAGE

From the Department of Neurology and Medical Eye Unit, St. Thomas' Hospital London SE1 7EH

Four patients with extensive occlusive disease of the extracranial arteries are described. All suffered attacks of visual loss due to transient retinal ischaemia and all developed the haemorrhagic changes of low-flow retinopathy. Resting cerebral blood flow was within normal limits in all patients. The attacks were provoked by falls in systemic blood pressure or, in one patient, by facial heating. The probable mechanism in this last case is thought to be diversion of blood to a dilated external carotid vascular bed. Temporary cerebral and brachial symptoms occurred but no permanent changes developed. Successful surgical reconstruction was achieved in two patients with relief of symptoms.

Received August 3, 1982. Revised November 23, 1982.
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