Hyperacute hyperperfusion intracerebral hemorrhage complicating carotid endarterectomy: A case report

Yun, So Hui; Park, Sang Hyun

Case Report

Neuroanesthesia

Anesthesia and Pain Medicine 2011;6(4):357-361.
Published online October 31, 2011.

Hyperacute hyperperfusion intracerebral hemorrhage complicating carotid endarterectomy: A case report

Department of Anesthesiology and Pain Medicine, College of Medicine, Jeju National University, Jeju, Korea. ppsshh11@hanmail.net

Abstract

Most complications of carotid endarterectomy originate from either thrombotic or embolic ischemia. Although the incidence of hemorrhagic hyperperfusion syndrome after carotid endarterectomy is extremely rare, it can cause significant morbidity and mortality. Several mechanisms are involved in the pathophysiology of cerebral hyperperfusion syndrome including impaired cerebral autoregulation and normal pressure breakthrough. Presently, a different mechanism is suggested. Unfortunately, suggestions for prevention are limited to strict perioperative control of hypertension in patients with critical stenosis and chronic cerebral hypoperfusion. We report hypertensive-like ipsilateral basal ganglia hemorrhage after carotid endarterectomy.

Key Words: Carotid endarterectomy, Cerebral hyperperfusion syndrome, Intracerebral hemorrhage