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Italian Journal of Vascular and Endovascular Surgery 2008 March;15(1):77-9

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Hyperperfusion syndrome post-carotid endarterectomy: early recognition is essential

Rai B. P. 1, Shakeel M. 2, Cassar K. 3

1 Department of General Surgery Aberdeen Royal Infirmary, Aberdeen, UK 2 Department of Surgery, Univeristy of Aberdeen Aberdeen Royal Infirmary, Aberdeen, UK 3 Department of Vascular Surgery Aberdeen Royal Infirmary, Aberdeen, UK


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Hyperperfusion syndrome consists of a triad of ipsilateral headache, seizures and focal neurological deficit. It occurs when the cerebral blood flow increases more than 100% of the preoperative cerebral blood flow. A 76 year-old lady underwent carotid endarterectomy for severe stenosis of the right internal carotid artery. She was known hypertensive and had complete occlusion of the contralateral internal carotid artery. Four days later she developed severe right-sided headache and then became unresponsive. A computed tomographic scan demonstrated a large intracranial haemorrhage. She died later that day. Early recognition of this condition and aggressive blood pressure control is essential to avoid serious outcomes.

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