Cargando…

Update on cerebral hyperperfusion syndrome

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 thrombecto...

Descripción completa

Detalles Bibliográficos
Autores principales: Lin, Yen-Heng, Liu, Hon-Man
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402457/
https://www.ncbi.nlm.nih.gov/pubmed/32414892
http://dx.doi.org/10.1136/neurintsurg-2019-015621
_version_ 1783566759623655424
author Lin, Yen-Heng
Liu, Hon-Man
author_facet Lin, Yen-Heng
Liu, Hon-Man
author_sort Lin, Yen-Heng
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7402457
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-74024572020-08-17 Update on cerebral hyperperfusion syndrome Lin, Yen-Heng Liu, Hon-Man J Neurointerv Surg Hemorrhagic Stroke 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. BMJ Publishing Group 2020-08 2020-05-15 /pmc/articles/PMC7402457/ /pubmed/32414892 http://dx.doi.org/10.1136/neurintsurg-2019-015621 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Hemorrhagic Stroke
Lin, Yen-Heng
Liu, Hon-Man
Update on cerebral hyperperfusion syndrome
title Update on cerebral hyperperfusion syndrome
title_full Update on cerebral hyperperfusion syndrome
title_fullStr Update on cerebral hyperperfusion syndrome
title_full_unstemmed Update on cerebral hyperperfusion syndrome
title_short Update on cerebral hyperperfusion syndrome
title_sort update on cerebral hyperperfusion syndrome
topic Hemorrhagic Stroke
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402457/
https://www.ncbi.nlm.nih.gov/pubmed/32414892
http://dx.doi.org/10.1136/neurintsurg-2019-015621
work_keys_str_mv AT linyenheng updateoncerebralhyperperfusionsyndrome
AT liuhonman updateoncerebralhyperperfusionsyndrome