title: Three cases of hyperperfusion syndrome identified by daily transcranial Doppler investigation after carotid surgery.
abstract: BACKGROUND
  cerebral hyperperfusion syndrome (HS), occurs in 0.5-1% of patients undergoing carotid endarterectomy (CEA), and may result in intracerebral haemorrhage and death.
  
  
  OBJECTIVE
  to diagnose HS by means of postoperative Transcranial Doppler (TCD).
  
  
  METHODS
  between 1998 and 2001 nearly all 112 patients who underwent CEA were monitored for four days postoperatively by Transcranial Doppler.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  daily TCD investigation in all patients undergoing CEA seems an effective strategy for the presymptomatic detection of HS.
authors.affiliation: Department of Clinical Neurophysiology, Martini Ziekenhuis Groningen, P.O. 30033, Groningen, 9700 RM Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Schaafsma
authors.forename: L v d
authors.initials: Lv
authors.lastname: Veen
authors.forename: J P M
authors.initials: JP
authors.lastname: Vos
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D013577:Syndrome; D017585:Ultrasonography, Doppler, Transcranial