Síndrome de hiperperfusão (pós-operatória) após três semanas da endarterectomia de carótida

Abstract

Síndrome de hiperperfusão (pós-operatória) após três semanas da endarterectomia de carótidaCerebral hyperperfusion syndrome occurring three weeks after carotid endarterectomy Abstract Cerebral hyperperfusion syndrome is a recognized complication of carotid endarterectomy. Various studies have documented an incidence of 0.3% to 1.2%. It occurs in the setting of sudden reperfusion of a chronically hypoperfused hemisphere. We present here a case of a 48-year-old lady who developed cerebral hyperperfusion syndrome three weeks after undergoing a carotid endarterectomy for high-grade carotid artery stenosis.Descriptors: Carotid endarterectomy, complications. Cerebrovascular accident. Cerebrovascular disorders, etiology. Resumo A síndrome de hiperperfusão pós-operatória (SH) é uma complicação conhecida após a endarterectomia de carótida.Vários estudos têm demonstrado uma incidência de 0,3% a 1,2%. Isso ocorre em situações de reperfusão súbita de um hemisfério com hipoperfusão crônica. Apresentamos, neste trabalho, o caso de uma paciente de 48 anos que desenvolveu SH três meses após ser submetida a uma endarterectomia de carótida por estenose grave da artéria carótida.Descritores: Endarterectomia das carótidas, complicações. Acidente cerebrovascular. Transtornos cerebrovasculares, etiologia. 117TORGOVNICK, J ET AL -Cerebral hyperperfusion syndrome occurring three weeks after carotid endarterectomy Braz J Cardiovasc Surg 2007; 22(1): 116-118

Revascularização simultânea do miocárdio e dos troncos supra-aórticos

“…Although we consider the possibility that this strategy could predispose to cerebral hyperperfusion syndrome [7] due to the function of cerebral blood flow during ECC, we chose to use it because the patient did not show reduced blood flow to the brain before the procedure, taking into consideration its asymptomatic aspects, and the low flow during ECC would represent a higher risk for a neurological event.…”

“…The extra-anatomic bypass of SAT performed via transsternal revascularization is associated with good late results, with acceptable levels of morbidity and mortality [7][8][9]. In the case described in this article, the bypass of the ascending aorta was performed to both common carotid arteries inserting Dacron graft.…”