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Hyperperfusion syndrome after carotid endarterectomy. CT changes.
P B Harrison1, M J Wong, A Belzberg
1Department of Radiology, St Paul's Hospital, Vancouver BC, Canada.
Neuroradiology
|January 1, 1991
Summary
Carotid endarterectomy can cause hyperperfusion syndrome, a condition characterized by headache and seizures. This syndrome, not infarction, may explain CT scan findings like mass effect and white matter hypodensity post-surgery.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Carotid endarterectomy is a surgical procedure to remove plaque from carotid arteries.
- Neurologic complications can occur after carotid endarterectomy.
- Hyperperfusion syndrome is a rare but serious complication.
Observation:
- Two patients developed headache and seizures post-carotid endarterectomy.
- CT scans revealed ipsilateral mass effect and white matter hypodensity.
- One patient experienced cerebral hemorrhage and expired.
Findings:
- CT findings suggested hyperperfusion syndrome rather than cerebral infarction.
- Autopsy and cerebral blood flow studies supported hyperperfusion as the cause.
- White matter hypodensity and mass effect are key CT indicators.
Implications:
- Recognizing hyperperfusion syndrome is crucial for accurate diagnosis after carotid endarterectomy.
- This finding challenges the assumption of infarction as the primary neurologic event.
- Improved understanding may lead to better patient management and outcomes.