Cerebral hyperperfusion syndrome following carotid endarterectomy

Adhiyaman, Vedamurthy; Alexander, S. Craighead

doi:10.1093/qjmed/hcm009

Cited by 66 publications

(75 citation statements)

References 51 publications

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“…Second: This hypotension can anticipated by an increase in cerebral blood flow when the blood pressure is returned to normal [11] The hyper perfusion syndrome was shown to be the cause of headache in multiple fields of medicine, for example after electroconvulsive therapy [12], after carotid end arterectomy [13] and seizure [14].…”

Section: Discussionmentioning

confidence: 99%

The Rate and Severity of Headache after Caesarean Section under Spinal Anaesthesia are decreased by Hypertonic Solutions: A Randomized Placebo-Controlled Clinical Trial

Khooshideh¹,

Shahriari²,

Bitarafan³

2017

Int J Neurorehabilitation Eng

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Section: Discussionmentioning

confidence: 99%

The Rate and Severity of Headache after Caesarean Section under Spinal Anaesthesia are decreased by Hypertonic Solutions: A Randomized Placebo-Controlled Clinical Trial

Khooshideh¹,

Shahriari²,

Bitarafan³

2017

Int J Neurorehabilitation Eng

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“…14,15 Based on these assumptions, a study to rule out OR of 5.5 for increased risk of symptomatic ICH in patients with CMBs versus those without would require a total sample of 120 patients (␣ϭ0.05, 80% power at 95% CI). One hundred forty-five potentially eligible subjects met the inclusion criteria and were recruited into the study during the study period.…”

Section: Discussionmentioning

confidence: 99%

“…However, ICH may occur in up to 5% of patients receiving stent-assisted angioplasty in association with the use of antithrombotics or hyperperfusion syndrome. 14,15 The purpose of this study is to evaluate the short-term risk of ICH in patients with ischemic stroke with CMBs who received dual antiplatelet therapy for endovascular intervention.…”

mentioning

confidence: 99%

Risk of Intracerebral Hemorrhage in Patients With Cerebral Microbleeds Undergoing Endovascular Intervention

Soo

Siu

Abrigo

et al. 2012

Stroke

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Background and Purpose-Cerebral microbleeds (CMBs) on MRI gradient echo images are hemosiderin deposits, which may predict intracerebral hemorrhage (ICH). The risk of ICH in patients with CMBs could be exacerbated by the use of antithrombotics. The purpose of our study is to prospectively evaluate the risk of ICH in patients with ischemic stroke who receive dual antiplatelet therapy for endovascular intervention. Methods-We analyzed MRI of 133 patients admitted consecutively for intra-and extracranial stenting for symptomatic large artery atherosclerosis who received aspirin and clopidogrel. Quantity and location of CMBs were recorded by neuroradiologists independent from the angioplasty team. The primary end point was symptomatic ICH as evident in CT of the brain within 12 weeks of procedure. Results-CMBs were identified in 23 patients. Mean number of CMBs was 2.3Ϯ1.6. Four patients had Ͼ5 CMBs.Forty-seven patients had intracranial stents, 84 patients had extracranial stents, and 2 patients had both intracranial and extracranial stents. There was no difference in risk of symptomatic ICH between those with (4.3%) and without CMBs (5.5%) patient with CMBs (Pϭ1.000). Conclusions-The presence of a small number of CMBs does not cause a large increase in the short-term risk of symptomatic ICH in patients with ischemic stroke who undergo endovascular intervention with dual antiplatelet therapy.

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“…Findings of decreased CBF together with MTT prolongation and a slight increase in CBV indicate that blood vessels are dilated, thus confirming that the autoregulation mechanism is impaired. Several authors have examined the role of CT and MRI in demonstrating hyperperfusion (Adhiyaman & Alexander 2007;Imai et al 2005;Sundt et al, 1981). Multislice dynamic susceptibility contrast MRI or perfusion-weighted MRI can also be used in the preoperative assessment of CBF (Fukuda et al, 2007;Wiart et al 2000).…”

Section: Diagnosing Cerebral Hyperperfusionmentioning

confidence: 99%