Related Experiment Video
Updated: May 27, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Incidence and clinical features of symptomatic cerebral hyperperfusion syndrome after vascular reconstruction
Kentaro Hayashi1, Nobutaka Horie, Kazuhiko Suyama
1Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki, Japan. kenkuni@net.nagasaki-u.ac.jp
Background:
Vascular reconstructions are the established treatment for ischemic cerebrovascular disease. Cerebral hyperperfusion syndrome (CHS) is occasionally seen after vascular reconstruction and manifest clinical symptoms. The purpose of this study is to investigate the incidence and clinical features of CHS after vascular reconstruction.
Methods:
A total of 144 patients with ischemic cerebrovascular disease (53 carotid endarterectomy [CEA] for carotid artery stenosis, 48 carotid artery stenting [CAS] for carotid artery stenosis, 20 bypass surgery for atherosclerotic cerebrovascular disease, 40 bypass surgery for moyamoya disease [MMD]) underwent vascular reconstruction. Patients were examined neurologically and radiologically, including computed tomography, magnetic resonance imaging, and single-photon-emission computed tomography, and then CHS was evaluated.
Results:
CHS developed in 1 (1.9%) CEA, 1 (2.1%) CAS, 1 (5.0%) bypass surgery for atherosclerotic cerebrovascular disease, and 6 (15.0%) bypass surgery for MMD. The incidence of CHS was significantly higher in patients with MMD. Aged patients and impairment of cerebrovascular reserve were correlated with CHS. Patients manifested disorientation after CEA and complained of headache after CAS. Diffuse hemispheric hyperperfusion was detected by single-photon-emission computed tomography. However, MMD patients manifested focal neurologic deficit, focal cerebral edema, and increased regional cerebral blood flow around vascular anastomosis. These patients were treated with blood pressure control and administration of free radical scavengers, and recovered without permanent deficits.
Conclusions:
The incidence of CHS is significantly higher in patients with MMD and results in vasogenic edema visible on magnetic resonance imaging.
More Related Videos
10:41Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound
Published on: June 3, 2021
09:14Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Related Concept Videos
Cerebral Edema ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Increased Intracranial Pressure ll: Pathophysiology
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke l: Introduction
Increased Intracranial Pressure l: Introduction