title: [Syndrome of cerebral hyperperfusion after carotid endarterectomy].
abstract: The aim of this study was to assess the role of different modalities in early diagnosis of cerebral hyperperfusion syndrome (CHPS) following carotid endarterectomy, as well as to develop effective treatment protocol for abovementioned complication.
  
  
  METHODS
  Study group consisted of 61 patient who underwent uni- or bilateral carotid endarterectomy (CEA). Diagnostic modalities included transcranial Doppler study (TCD), cerebral oximetry, perfusion CT scanning and neuropsychological evaluation.
  
  
  RESULTS
  We demonstrated that both bilateral carotid stenosis and stroke were independent predictive factors for CHPS at early postoperative period. "Classical" two-fold increase of cerebral blood flow in ipsilateral CMA was seen in 15% patients only. According to our data, predictive TCD-value was 1.48 increase of CBF. The most informative tool for early CHPS diagnosis was perfusion CT scans: preoperative mean transit time asymmetry in temporal areas (in the group of patients with unilateral carotid stenosis) correlated with CHPS development. Effective medical treatment for CHPS was achieved with Ca2+ channel antagonists use, that enabled us to prevent evolution of "mild" clinical appearance of CHPS into status epilepticus or intracerebral hemorrhage.
  
  
  CONCLUSIONS
  Modern diagnostic modalities that assess brain perfusion can (with certain rate of accuracy) predict CHPS development even preoperatively. Early therapy of this complication with Ca2+ antagonists can usually control it.
authors: A Iu
authors: AIu
authors: Beliaev
authors: D Iu
authors: DIu
authors: Usachev
authors: V A
authors: VA
authors: Lukshin
authors: O B
authors: OB
authors: Sazonova
authors: A V
authors: AV
authors: Shmigel'skiĭ
authors: A E
authors: AE
authors: Podoprigora
mesh_terms: D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D016893:Carotid Stenosis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D002560:Cerebrovascular Circulation; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D012189:Retrospective Studies; D020521:Stroke; D013577:Syndrome
chemical_list: D002121:Calcium Channel Blockers