naa a22 4500 510799841 CHVBK 20180411083350.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12028-012-9733-x doi (NATIONALLICENCE)springer-10.1007/s12028-012-9733-x Hyperperfusion Syndrome after Stent/Coiling of a Ruptured Carotid Bifurcation Aneurysm [Elektronische Daten] [Robert Ecker, Richard Murray, David Seder] The authors report a syndrome of regional, symptomatic cerebral hyperperfusion, and edema mimicking infarction in a 54-year-old woman following coiling of a ruptured right carotid bifurcation aneurysm and stenting of the right middle cerebral artery. The patient presented with a Hunt and Hess grade III subarachnoid hemorrhage 7days after developing thunderclap headache. She underwent successful coiling under general anesthesia of the 1.6×1.5×1.6cm aneurysm, but immediately after the coil was placed occlusion of the proximal M1 segment was developed. This occlusion was stented after ~5-min delay, and flow restored without angiographic evidence of distal emboli. Following the procedure, she was extubated and noted to have left hemiparesis, neglect, and mutism without a CT correlate. Cerebral infarction was suspected, but urgent repeat angiography demonstrated patent cerebral vasculature. On the following day, symptoms persisted, and non-contrast head CT now showed cerebral edema localized to the right middle cerebral artery territory mimicking subacute infarction. CT perfusion imaging and angiography showed a widely patent MCA circulation, and suggested a regional hyperperfusion syndrome. The blood pressure was incrementally lowered, with rapid and sustained neurological improvement. Hyperperfusion events following aneurysm repair and related circumstances are reviewed. Springer Science+Business Media, LLC, 2012 Hyperperfusion nationallicence Coil nationallicence Stent nationallicence Endothelial dysfunction nationallicence Cerebral edema nationallicence Subarachnoid hemorrhage nationallicence Ecker Robert Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut Murray Richard Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut Seder David Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut Neurocritical Care Humana Press Inc 18/1(2013-02-01), 54-58 1541-6933 18:1<54 2013 18 12028 https://doi.org/10.1007/s12028-012-9733-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9733-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ecker Robert Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut NATIONALLICENCE 700 1- Murray Richard Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut NATIONALLICENCE 700 1- Seder David Departments of Surgery (RDE, RDM), Critical Care Medicine (DBS), Maine Medical Center, 49 Spring Street, Scarborough, 04074, Portland, ME, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/1(2013-02-01), 54-58 1541-6933 18:1<54 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer