title: [Study of background factors of cerebral hyperperfusion syndrome in the anesthetic management of carotid endarterectomy].
abstract: BACKGROUND
  We conducted a retrospective study to evaluate background factors of cerebral hyperperfusion syndrome (CHS) in the anesthetic management of carotid endarterectomy (CEA) for carotid artery stenosis.
  
  
  METHODS
  A total of 118 ASA 1-2 adult patients were allocated to one of two groups: Group A of 13 patients who developed CHS after CEA, and Group B of the remaining 105 patients. We weighed control percent ratio of somatosensory evoked potential (%SEP). The rate of carotid artery stenosis, stump pressure of internal carotid artery, %SEP internal carotid artery blood flow (ICF), and preoperative anesthetic problems were compared between the two groups.
  
  
  RESULTS
  The rate of carotid artery stenosis in Group A was 85%, significantly higher than 74% of Group B. Stump pressure in Group A was 28 mmHg, significantly lower than 37 mmHg of Group B. %SEP was 67% of Group A, and 87% of Group B, respectively ICF in Group A was 7+ +/- 33 ml min(-1), which decreaced significantly compared with 78 +/- 34 ml min(-1) of Group B.
  
  
  CONCLUSIONS
  We conclude that the patients with high rate of carotid artery stenosis, low stump pressure and low ICF have a high risk of developing CHS after CEA and careful attention should be required in the anesthetic management of CEA.
authors.affiliation: Department of Anesthesia, Chugoku Rosai General, Hospital, Kure 737-0193.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kajiyama
authors.forename: Itsuo
authors.initials: I
authors.lastname: Nakagawa
authors.forename: Shozo
authors.initials: S
authors.lastname: Hidaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okada
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Koga
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sone
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001775:Blood Circulation; D002343:Carotid Artery, Internal / Q000503:physiopathology; D016893:Carotid Stenosis / Q000601:surgery*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000209:etiology*; D016894:Endarterectomy, Carotid; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011312:Pressure; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome