Postcarotid endarterectomy hyperperfusion or reperfusion syndrome.

Détails

ID Serval
serval:BIB_C50D8E329252
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Postcarotid endarterectomy hyperperfusion or reperfusion syndrome.
Périodique
Stroke
Auteur(s)
Karapanayiotides T., Meuli R., Devuyst G., Piechowski-Jozwiak B., Dewarrat A., Ruchat P., Von Segesser L., Bogousslavsky J.
ISSN
1524-4628
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
36
Numéro
1
Pages
21-26
Langue
anglais
Notes
Case Reports Journal Article Research Support, Non-U.S. Gov't --- Old month value: Jan
Résumé
BACKGROUND AND PURPOSE: Hyperperfusion syndrome (HS) after carotid endarterectomy (CEA) has been related to impaired cerebrovascular autoregulation in a chronically hypoperfused hemisphere. Our aim was to provide new insight into the pathophysiology of the HS using magnetic resonance imaging (MRI) studies with diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI). METHODS: Five out of 388 consecutive patients presented 2 to 7 days after CEA, partial seizures (n=5), focal deficits (n=5), and intracerebral hemorrhage (n=3). In 4 patients, using sequential examinations, we identified vasogenic or cytotoxic edema by DWI; we assessed relative interhemispheric difference (RID) of cerebral blood flow (CBF) by PWI; and we measured middle cerebral artery mean flow velocities (MCA Vm) by transcranial Doppler (TCD). RESULTS: None of the patients presented pathological DWI hyperintensities, consistent with the absence of acute ischemia or cytotoxic edema. In 2 patients, we found an MRI pattern of reversible vasogenic edema similar to that observed in the posterior leukoencephalopathy syndrome. Middle cerebral artery (MCA) mean flow velocities (Vm) were not abnormally increased at any time. PWI documented a 20% to 44% RID of CBF in favor of the ipsilateral to CEA hemisphere. CONCLUSIONS: HS can occur in the presence of moderate relative hyperperfusion of the ipsilateral hemisphere. MCA Vm values may not accurately reflect RID of CBF over the cortical convexity. We suggest that the hemodynamic pathogenetic mechanisms of the HS are more complicated than hitherto believed and that they may be more accurately described by the term "reperfusion syndrome."
Mots-clé
Aged, Cerebral Hemorrhage, Cerebrovascular Circulation, Cerebrovascular Disorders, Diffusion Magnetic Resonance Imaging, Endarterectomy, Carotid, Female, Humans, Magnetic Resonance Angiography, Male, Reperfusion Injury, Seizures, Syndrome, Tomography, X-Ray Computed, Ultrasonography, Doppler, Transcranial
Pubmed
Web of science
Open Access
Oui
Création de la notice
08/04/2008 15:48
Dernière modification de la notice
09/05/2019 0:58
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