Update on cerebral hyperperfusion syndrome

被引:112
作者
Lin, Yen-Heng [1 ]
Liu, Hon-Man [2 ,3 ]
机构
[1] Natl Taiwan Univ Hosp, Med Imaging, Taipei 10016, Taiwan
[2] Natl Taiwan Univ, Radiol, Taipei, Taiwan
[3] Fu Jen Catholic Univ, Fu Jen Catholic Univ Hosp, Med Imaging, New Taipei 24352, Taiwan
关键词
complication; hemorrhage; stent; stroke; WINGSPAN STENT SYSTEM; INTRACRANIAL HEMORRHAGE; CAROTID-ENDARTERECTOMY; RISK-FACTORS; STENOSIS; THERAPY; DISEASE; MRI;
D O I
10.1136/neurintsurg-2019-015621
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Cerebral hyperperfusion syndrome (CHS) is a clinical syndrome following a revascularization procedure. In the past decade, neurointerventional surgery has become a standard procedure to treat stenotic or occluded cerebral vessels in both acute and chronic settings, as well as endovascular thrombectomy in acute ischemic stroke. This review aims to summarize relevant recent studies regarding the epidemiology, diagnosis, and management of CHS as well as to highlight areas of uncertainty. Extracranial and intracranial cerebrovascular diseases in acute and chronic conditions are considered. The definition and diagnostic criteria of CHS are diverse. Although impaired cerebrovascular autoregulation plays a major role in the pathophysiology of CHS, the underlying mechanism is still not fully understood. Its clinical characteristics vary in different patients. The current findings on clinical and radiological presentation, pathophysiology, incidence, and risk factors are based predominantly on carotid angioplasty and stenting studies. Hemodynamic assessment using imaging modalities is the main form of diagnosis although the criteria are distinct, but it is helpful for patient selection before an elective revascularization procedure is conducted. After endovascular thrombectomy, a diagnosis of CHS is even more complex, and physicians should consider concomitant reperfusion injury. Management and preventative measures, including intensive blood pressure control before, during, and after revascularization procedures and staged angioplasty, are discussed in detail.
引用
收藏
页码:788 / 793
页数:7
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