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Updated: Nov 8, 2025
Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion
Published on: February 17, 2013
Cerebral hyperperfusion syndrome after intracranial stenting: Case report and systematic review
Francesco Diana1, Giulia Frauenfelder1, Annibale Botto1
1Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, 19028University of Salerno, Salerno, Italy.
Insights
Cerebral Hyperperfusion Syndrome (CHS) is a rare complication after intracranial angioplasty. Pseudo-Continuous Arterial Spin Labeling Perfusion MRI can help diagnose CHS early.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Cerebral Hyperperfusion Syndrome (CHS) is an infrequent complication following intracranial angioplasty and stenting (INCS).
- Increasing use of INCS necessitates better understanding of its associated risks, including CHS.
- This case highlights CHS in a patient treated for severe internal carotid artery siphon stenosis.
Observation:
- A 63-year-old male developed seizures and respiratory failure post-INCS.
- Conventional imaging revealed no acute brain lesions.
- Pseudo-Continuous Arterial Spin Labeling (PCASL) Perfusion MRI detected increased right hemisphere blood flow, indicative of CHS.
Findings:
- PCASL Perfusion MRI demonstrated early signs of CHS.
- The imaging findings correlated with the patient's clinical presentation.
- This suggests PCASL's utility in diagnosing CHS.
Implications:
- Monitoring perfusion changes post-INCS is crucial for identifying patients at high risk of CHS.
- ASL Perfusion MRI offers a prompt and early diagnostic tool for CHS.
- This technique can aid in timely management of CHS after intracranial artery stenosis treatment.
Background:
Cerebral Hyperperfusion Syndrome (CHS) is an uncommon complication observed after intracranial angioplasty or stenting procedures. Given to the increasing use of new devices for intracranial angioplasty and stenting (INCS), in selected patients with high ischemic stroke risk, an equally increasing knowledge of complications related to these procedures is mandatory.Case description: a 63-year-old man was diagnosed with an hyperperfusion syndrome after percutaneous angioplasty and stenting for severe symptomatic right internal carotid artery (ICA) siphon stenosis. After treatment he complained generalized seizures and respiratory failure. While conventional imaging did not demonstrate any acute brain lesions, Pseudo-Continuous Arterial Spin Labeling (PCASL) Perfusion MRI early documented right hemisphere blood flow increase suggestive for CHS.
Conclusions:
Monitoring of perfusion changes after INCS could play an important a role in determining patients with high risk of CHS. ASL Perfusion MRI might be used for promptly, early diagnosis of CHS after treatment of severe intracranial artery stenosis.
