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
Carotid artery stenosis is a narrowing or constriction of any part of the carotid artery, carotid arteries, usually caused by atherosclerosis.
Signs and symptoms
The common carotid artery is the large artery whose Common carotid artery#Clinical ...
. Risk factors include hypertension, particularly high blood pressures in the first few days following revascularization and bilateral stenosis.
Symptoms
The first symptom is usually severe headache, and a headache in the setting of recent
carotid endarterectomy
Carotid endarterectomy is a surgical procedure used to reduce the risk of stroke from carotid artery stenosis (narrowing the internal carotid artery). In an endarterectomy, the surgeon opens the artery and removes the plaque. The plaque forms ...
or
carotid stenting
Carotid artery stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery i ...
should prompt a return to the hospital and close attention by clinicians. Symptoms may progress to
seizures
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, o ...
and
coma
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to Nociception, respond normally to Pain, painful stimuli, light, or sound, lacks a normal Circadian rhythm, sleep-wake cycle and does not initiate ...
in severe cases.
Treatment
Treatment is control of the blood pressure, often with continuous intravenous antihypertensives medicines in the intensive care setting.
Seizures may require treatment with
anti-seizure medication.
References
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Brain disorders
Cardiovascular physiology
Neurotrauma