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Three Cases of Hyperperfusion Syndrome Identified by Daily Transcranial Doppler Investigation After Carotid Surgery

https://doi.org/10.1053/ejvs.2001.1545Get rights and content
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Abstract

Background: cerebral hyperperfusion syndrome (HS), occurs in 0.5–1% of patients undergoing carotid endarterectomy (CEA), and may result in intracerebral haemorrhage and death. Aim: to diagnose HS by means of postoperative Transcranial Doppler (TCD). Methods: between 1998 and 2001 nearly all 112 patients who underwent CEA were monitored for four days postoperatively by Transcranial Doppler. Results: there were 3 patients with HS. All three showed TCD abnormalities hours before developing symptoms. One patient developed a full blown HS. Presumably, symptoms in the other two patients could be prevented by timely starting or restoring anti-hypertensive treatment. Conclusion: daily TCD investigation in all patients undergoing CEA seems an effective strategy for the presymptomatic detection of HS.

Keywords

CEA
Hyperperfusion
Endarterectomy
Carotid artery
Carotid stenosis
Carotid surgery
Blood flow velocity
Ultrasonography
Hypertension
Transcranial Doppler
Cerebral arteries.

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Please address all correspondence to: A. Schaafsma, Afd. Klinische Neurofysiologie, Martini Ziekenhuis Groningen, Postbus 30033, 9700 RM Groningen.