Hyperperfusion Syndrome Following Tissue Plasminogen Activator Administration: A Case Report with Radiological...

Area of Science:

• Neurology
• Vascular Surgery

Background:

• Cerebral hyperperfusion syndrome (CHS) is a known complication after carotid artery revascularization.
• CHS solely from intravenous tissue plasminogen activator (tPA) without revascularization is exceptionally rare, with only four prior reported cases.

Observation:

• This report details a case of early neurological deterioration in acute ischemic stroke.
• The patient experienced this deterioration following intravenous tPA administration.

Findings:

• Imaging evidence confirmed the neurological deterioration as a form of cerebral hyperperfusion syndrome.
• This finding supports the occurrence of CHS after intravenous tPA in the absence of revascularization.

Implications:

• This case expands the understanding of CHS triggers, particularly in acute ischemic stroke management.
• It underscores the importance of considering CHS in patients receiving intravenous tPA, especially those with underlying vascular risk factors.