Cerebral hyperperfusion syndrome

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.

"Reperfusion syndrome" redirects here. For Ischemia-Reperfusion injury, see Reperfusion injury.

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.

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.
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