title: Hyperperfusion syndrome after MCA embolectomy - a rare complication?
abstract: METHODS
  Female, 78 FINAL DIAGNOSIS: Cerebral hyperperfusion syndrome Symptoms: -
  
  
  METHODS
  - Clinical Procedure: Endovascular embolectomy Specialty: Neurology.
  
  
  OBJECTIVE
  Unknown ethiology.
  
  
  BACKGROUND
  Cerebral hyperperfusion syndrome (cHS) is a well known but rare complication after carotid endarterectomy, carotid angioplasty with stenting, and stenting of intracranial arterial stenosis. The clinical presentation may vary from acute onset of focal oedema (stroke-like presentation) and intracerbral hemorrhage to delayed (>24h hours after the procedure) presentation with seizures, focal motor weakness, or late intracerebral hemorrhage. The incidence of cHS after carotid endarterectomy ranges from 0-3% and defined as an increase of the ipsilateral cerebral blood flow up to 40% over baseline in ultrasound.
  
  
  METHODS
  We present a case of a 78-year-old woman with an acute ischemic stroke due to left side middle cerebral artery territory with right sided hemiparesis and aphasia (NIHSS 16). After systemic thrombolysis embolectomy using a retractable stent (Solitaire(®) device) was performed and resulted in complete and successful recanalization of MCA including its branches about 210 minutes after symptom onset but, partial dislocation of thrombotic material into the anterior cerebral artery (ACA).
  
  
  CONCLUSIONS
  Cerebral hyperperfusion syndrome should be considered in patients with clinical deterioration after successful recanalisation and the early diagnosis and treatment may be important for neurological outcome after endovascular embolectomy.
authors: Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany.
authors: Roland
authors: R
authors: Backhaus
authors: Sandra
authors: S
authors: Boy
authors: Kornelius
authors: K
authors: Fuchs
authors: Bogdahn
authors: B
authors: Ulrich
authors: Gerhard
authors: G
authors: Schuierer
authors: Felix
authors: F
authors: Schlachetzki
keywords: embolectomy; hyperperfusion syndrome; ischemic stroke; middle cerebral artery occlusion