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Cerebral hyperperfusion syndrome, also known as reperfusion syndrome, is a dysregulated state of cerebral blood flow following the restoration of arterial blood flow to the brain, usually following treatment of carotid artery stenosis. [1]
Reperfusion injury, sometimes called ischemia-reperfusion injury (IRI) or reoxygenation injury, is the tissue damage caused when blood supply returns to tissue (re-+ perfusion) after a period of ischemia or lack of oxygen (anoxia or hypoxia).
Following surgery, a rare early complication is cerebral hyperperfusion syndrome, also known as reperfusion syndrome, which is associated with headache and high blood pressure following surgery. Long term complications include restenosis of the endarterectomy bed, although the clinical significance of this is controversial in asymptomatic patients.
Cerebral Hyperperfusion Syndrome leading to stroke is a serious complication of carotid artery angioplasty with stenting. [27] Angioplasty may also provide a less durable treatment for atherosclerosis and be more prone to restenosis relative to vascular bypass or coronary artery bypass grafting. [28]
Watershed stroke symptoms are due to the reduced blood flow to all parts of the body, specifically the brain, thus leading to brain damage. Initial symptoms, as promoted by the American Stroke Association, are FAST, representing F = Facial weakness (droop), A = Arm weakness (drift), S = Speech difficulty (slur), and T = Time to act (priority of intervention).
In many cases there is evidence of constriction of the blood vessels (if angiography is performed), suggesting a possible overlap with reversible cerebral vasoconstriction syndrome (RCVS). Diffusion MRI may be used to identify areas of cytotoxic edema caused by poor blood flow (ischemia) but it is not clear if this prognostically relevant.
Proposed consequences of CCSVI syndrome include intracranial hypoxia, delayed perfusion, reduced drainage of catabolites, increased transpulmonary pressure, [18] and iron deposits around the cerebral veins. [19] [20] Multiple sclerosis has been proposed as a possible outcome of CCSVI. [21]
Partial anterior circulation infarct (PACI) is a type of cerebral infarction affecting part of the anterior circulation supplying one side of the brain.. Partial anterior circulation stroke syndrome (PACS) refers to the symptoms of a patient who clinically appears to have had a partial anterior circulation infarct, but who has not yet had any diagnostic imaging (e.g. CT Scan) to confirm the ...