Cerebral hyperperfusion syndrome

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Cerebral hyperperfusion syndrome, also known as reperfusion syndrome, is a dysregulated state of cerebral blood flow following the restoration of arterial blood flow to the brain, usually following treatment of carotid artery stenosis. [1] Risk factors include hypertension, particularly high blood pressures in the first few days following revascularization and bilateral stenosis.

Contents

Symptoms

The first symptom is usually severe headache, and a headache in the setting of recent carotid endarterectomy or carotid stenting should prompt a return to the hospital and close attention by clinicians. Symptoms may progress to seizures and coma in severe cases.

Treatment

Treatment is control of the blood pressure, often with continuous intravenous antihypertensives medicines in the intensive care setting. [2] Seizures may require treatment with anti-seizure medication.

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<span class="mw-page-title-main">Brajesh K. Lal</span>

Brajesh K. Lal, born in 1963 in Varanasi, India and of Indian origin, is an American surgeon, and an expert in vascular disease, particularly the prevention and treatment of stroke and venous disease. He is a tenured Professor of Vascular Surgery at the University of Maryland and Professor of Neurology at Mayo Clinic. He holds additional appointments at the Departments of Bioengineering at the University of Maryland and George Mason University. He founded and currently directs the multi-specialty Center for Vascular Research and the NIH Vascular Imaging Core Facility at the University of Maryland. He has been elected as a Distinguished Fellow of the Society for Vascular Surgery and Distinguished Fellow of the American Venous Forum.

References

  1. Farooq, MU; Goshgarian, C; Min, J; Gorelick, PB (2016). "Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid artery stenting". Experimental & Translational Stroke Medicine. 8 (1): 7. doi: 10.1186/s13231-016-0021-2 . PMC   5012059 . PMID   27602202.
  2. Kirchoff-Torres, KF; Bakradze, E (19 March 2018). "Cerebral Hyperperfusion Syndrome After Carotid Revascularization and Acute Ischemic Stroke". Current Pain and Headache Reports. 22 (4): 24. doi:10.1007/s11916-018-0678-4. PMID   29556806.