Cerebral hyperperfusion syndrome after internal carotid artery dissection with persistent occlusion

Pinho, João; Amorim, José Manuel; Alves, José Nuno; Araújo, José Manuel; Ferreira, Carla

doi:10.1007/s10072-016-2517-x

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…This study showed that preoperative hypertension has no definitive value in predicting postoperative CHS, probably because both the CHS and non-CHS groups had high detection rates of hypertension. However, this study, along with others ( 13 , 14 ), still suggests that the postoperative control of blood pressure is very important for the prevention of CHS. This is because after a successful opening of blood vessels with stenosis, a high-blood pressure will rapidly increase the cerebral perfusion pressure, leading to further damage to the cerebrovascular barrier and causing CHS.…”

Section: Discussionmentioning

confidence: 58%

Risk factors and preventive measures of cerebral hyperperfusion syndrome after carotid artery interventional therapy

Wang

Cheng

Li³

2017

Experimental and Therapeutic Medicine

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This study sought to investigate the risk factors for cerebral hyperperfusion syndrome (CHS) after carotid artery interventional therapy, and to explore potential preventive measures. Three hundred and eighty-two patients treated with carotid artery stenting at the Huanhu Hospital (Tianjin, China) between January 2010 and January 2016 were divided into CHS and non-CHS groups. A retrospective analysis of patient clinical data was made. The CHS group had more patients presenting coronary heart disease, diabetes, progressive neurological disease and transient recurrent cerebral hemorrhage than the non-CHS group. More patients in the CHS group presented stenosis of the internal carotid artery siphon. More CHS group patients showed plaque formation extending >3 cm to the distal end of the internal carotid artery. Finally, more CHS group patients had pressure gradients >60 mmHg (p<0.05). Logistics regression analysis showed that preoperative diabetes mellitus and carotid pressure gradient ≥60 mmHg were independent risk factors for CHS (p<0.05). The ROC curve of carotid pressure gradients ≥60 mmHg were made to predict CHS, with the area under curve being 0.949 (p<0.05). The best cut-off value was 60 mmHg. Therefore, preoperative diabetes and a carotid pressure gradient ≥60 mmHg are risk factors for CHS, and these indicators need to be examined prior to operation.

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Section: Discussionmentioning

confidence: 58%

Risk factors and preventive measures of cerebral hyperperfusion syndrome after carotid artery interventional therapy

Wang

Cheng

Li³

2017

Experimental and Therapeutic Medicine

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“…After stent implantation, vascular stenosis rapidly relieves and the intracranial blood flow increases sharply, leading to a sharp increase in capillary bed perfusion pressure. These events cause the cerebrovascular system not to contract timely and effectively, which is an obstacle of the blood brain barrier mechanism and leads to brain edema and intracranial hemorrhage (5,6). Occasionally the clinical symptoms are not obvious, and can easily be ignored (7).…”

Section: Discussionmentioning

confidence: 99%

Correlation between high perfusion syndrome and stent restenosis after stent implantation

Tang

Dong

et al. 2016

Experimental and Therapeutic Medicine

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The present study was conducted to determine the correlation between high perfusion syndrome and stent restenosis after cerebral vascular stent implantation. A total of 146 patients diagnosed with cerebral vascular stenosis and stent implantation were selected. A total of 55 cases (37.67%) of cerebral hyperperfusion syndrome patients were diagnosed by xenon-enhanced computer tomography (Xe-CT) examination and clinical symptoms within 3 days after surgery and were chosen as the observation group. A total of 91 cases were selected as the control group. After treatment, blood flow of the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, anterior border zone, posterior border zone and the inner border zone of the two groups increased, with values in the observation group increasing more significantly, and the differences were statistically significant (P<0.05). The rate of restenosis and target lesion diameter one month and one year after operation in the observation group were significantly higher than those in the control group (P<0.05). Multivariate logistic regression analysis showed that the mean systolic blood pressure (mSBP), mean diastolic blood pressure (mDBP), stenosis rate of cerebral vascular diameter and high perfusion syndrome were independent risk factors for restenosis (P<0.05). The application of Xe-CT examination is important for early diagnosis of hyperperfusion syndrome. Hyperperfusion syndrome and the occurrence of stent restenosis are closely related. mSBP, mDBP, cerebral blood vessel diameter stenosis rate and high perfusion comprehensive syndrome are the independent risk factors of restenosis.

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“…Imaging presentation includes brain edema and hemorrhage, whereas transcranial Doppler (TCD) ultrasound shows higher velocity than in the contralateral vessel. [1–3] Alternatively, reperfusion injury is not well studied during the acute stage following artery recanalization, but is also associated with hemorrhagic transformation (HT) and brain edema. [4] The 2 phenomena have distinct etiologies and are differentiated easily although rarely in clinical practice.…”

Section: Introductionmentioning

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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Cerebral hyperperfusion syndrome after internal carotid artery dissection with persistent occlusion

Cited by 3 publications

References 5 publications

Risk factors and preventive measures of cerebral hyperperfusion syndrome after carotid artery interventional therapy

Risk factors and preventive measures of cerebral hyperperfusion syndrome after carotid artery interventional therapy

Correlation between high perfusion syndrome and stent restenosis after stent implantation

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

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