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Journal of Neurology

, Volume 244, Issue 2, pp 101–104 | Cite as

Cerebral hyperperfusion injury after percutaneous transluminal angioplasty of extracranial arteries

  • B. G. H. Schoser
  • Christoph Heesen
  • Bernd Eckert
  • Andreas Thie
Original communication

Abstract

Cerebral hyperperfusion syndrome after carotid endarterectomy (CEA) is a rare but well-known phenomenon. Percutaneous transluminal angioplasty (PTA) is being widely evaluated for treatment of selected stenoses of the extracranial arteries. Its benefits and risks still need to be established. Hyperperfusion injury (HI) after PTA of cerebral arteries has not been reported. We describe two patients with severe HI, one with a small putaminal haemorrhage and the other with diffuse basal subarachnoid haemorrhage. In both cases, a typical clinical hyperperfusion syndrome with headache, confusion, vomiting and seizures occurred. Patient 1 underwent PTA of the left carotid artery, both subclavian arteries and proximal vertebral arteries, patient 2 had carotid angioplasty only. Transcranial Doppler ultrasound displayed markedly elevated blood-flow velocities. HI may occur after PTA of extracranial arteries. The pathogenesis might be similar to reperfusion injury after CEA. Our findings suggest that: (1) HI may occur after PTA; (2) patients should be monitored after PTA for HI; (3) further risk factors for HI need to be identified.

Key words Hyperperfusion syndrome Reperfusion injury Angioplasty 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • B. G. H. Schoser
    • 1
  • Christoph Heesen
    • 1
  • Bernd Eckert
    • 2
  • Andreas Thie
    • 1
  1. 1.Department of Neurology, University of Hamburg, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany Tel.: 49-40-4717-3771, Fax: 49-40-4717-5086DE
  2. 2.Department of Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, GermanyDE

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