Cerebral hyperperfusion syndrome: A novel presentation of internal carotid artery dissection

Pinho, João; Rocha, Sofia; Varanda, Sara; Ribeiro, Manuel; Rocha, Jaime; Ferreira, Carla

doi:10.1212/wnl.0b013e31829e6f26

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…The pathogenesis of CHS is not clear, [2] and some case reports [7–8] speculated that damage to pericarotid sympathetic fibers results in loss of vasoconstriction in large and small intracranial arteries, leading to a degree of hypertension exceeding the ameliorative capacity of small arteriole myogenic autoregulation. Alternatively, reperfusion injury has been defined in numerous ways, including activation of endothelium, excess production of oxygen free radicals, inflammatory responses and leukocyte recruitment, increased cytokine production, and edema formation.…”

Section: Discussionmentioning

confidence: 99%

A case of cerebral hyperperfusion following spontaneous recanalization of occluded middle cerebral artery

Zhou²,

Liu³

et al. 2017

Medicine

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Background:Cerebral hyperperfusion syndrome (CHS) and reperfusion injury are distinct pathological phenomena.Case summary:We present the case of a young ischemic stroke patient with middle cerebral artery (MCA) occlusion and spontaneous recanalization. Follow-up transcranial Doppler ultrasound showed high velocity flow in the left MCA, and neuroimaging revealed infarction, brain edema, artery dilatation, and hyperperfusion, consistent with both CHS and reperfusion injury.Conclusion:In cases with signs of both CHS and reperfusion injury, we speculate that CHS may be both a contributor to and a manifestation of reperfusion injury.

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Section: Discussionmentioning

confidence: 99%

A case of cerebral hyperperfusion following spontaneous recanalization of occluded middle cerebral artery

Zhou²,

Liu³

et al. 2017

Medicine

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Cerebral hyperperfusion syndrome after internal carotid artery dissection with persistent occlusion

et al. 2016

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Clinical significances and features of prompt brain CT scan after intracranial artery stenting: analysis of 501 cases

Cheng

Xiong

et al. 2017

Oncotarget

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Cerebral hemorrhage is a serious complication of intracranial artery stenting that could be fatal without timely identification and treatment. Prompt brain CT scan would help to evaluate whether cerebral hemorrhage occurs, however, the diverse features of the CT scan immediately after stenting could influence the judgement sometimes. Therefore, we analyzed and summarized these features to help to determine the clinical significance of these CT features. The prompt CT features after stenting were classified into three types. Type I indicates that no high-density shadows. Type II indicates that high-density shadows scattered in the infarct areas and/or subarachnoid spaces without mass effect. Type III indicates high-density shadows scattered in and/or out of the infarct areas and/or subarachnoid space with obvious mass effects. Based on this classification, the patients in both Type I and II would continue the double anti-platelet treatment (DAPT) and anti-coagulation treatment, while the later need closer monitoring. However, patients in Type III must immediately withdraw the DAPT and anti-coagulation treatment with close monitoring and surgical intervention was needed when necessary. Nineteen (3.79%) patients were classified into Type III, and 5 (1.00%) of the 19 were accepted surgical intervention. Two of these patients died (0.40%). The prompt CT scan timely distinguishing the cerebral hemorrhage was necessary after intracranial artery stent angioplasty. Additionally, based on the different prompt CT features to take different therapeutic strategies after stenting would achieve better outcomes for ischemic stroke or transient ischemic stroke (TIA) patients underwent intracranial artery endovascular therapy.

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Cerebral hyperperfusion syndrome: A novel presentation of internal carotid artery dissection

Cited by 4 publications

References 7 publications

A case of cerebral hyperperfusion following spontaneous recanalization of occluded middle cerebral artery

A case of cerebral hyperperfusion following spontaneous recanalization of occluded middle cerebral artery

Cerebral hyperperfusion syndrome after internal carotid artery dissection with persistent occlusion

Clinical significances and features of prompt brain CT scan after intracranial artery stenting: analysis of 501 cases

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