Three cases of hyperperfusion syndrome identified by daily transcranial Doppler investigation after carotid surgery.

Abstract

cerebral hyperperfusion syndrome (HS), occurs in 0.5-1% of patients undergoing carotid endarterectomy (CEA), and may result in intracerebral haemorrhage and death. to diagnose HS by means of postoperative Transcranial Doppler (TCD). between 1998 and 2001 nearly all 112 patients who underwent CEA were monitored for four days postoperatively by Transcranial Doppler. there were 3 patients with HS. All three showed TCD abnormalities hours before developing symptoms. One patient developed a full blown HS. Presumably, symptoms in the other two patients could be prevented by timely starting or restoring anti-hypertensive treatment. daily TCD investigation in all patients undergoing CEA seems an effective strategy for the presymptomatic detection of HS.