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FIG 5. A 75-year-old man with symptomatic lacunar infarcts in the right cerebral hemisphere and asymptomatic left ICA stenosis (90%) that exhibited hyperperfusion syndrome 6 days after CEA.
A, SPECT scans obtained preoperatively (left) and immediately after CEA (right) show postoperative hyperperfusion in the entire ipsilateral cerebral hemisphere.
B, TCD monitoring of the left middle cerebral artery during CEA reveals systolic blood flow velocity of 2.9-fold of preclamp values immediately after declamping. The value increased to 3.6-fold at the end of the procedure.
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