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Hyperperfusion syndrome after trapping with high-flow bypass for a giant paraclinoid internal carotid artery aneurysm.
World Neurosurg. 2018 Apr 21;:
Authors: Mohri M, Ichinose T, Uchiyama N, Misaki K, Nambu I, Takabatake Y, Nakada M
Abstract
BACKGROUND: Hyperperfusion syndrome associated with aneurysm surgery is rare. The occurrence of the syndrome after trapping with high-flow bypass has not been described previously. Herein, we present a case of the syndrome occurring after trapping with high-flow bypass of an unruptured giant paraclinoid internal carotid artery (ICA) aneurysm.
CASE DESCRIPTION: The patient was a 68-year-old woman with progressive loss of vision in her left eye. After a diagnosis of a left giant ICA aneurysm, she underwent successful trapping with high-flow bypass. No new neurological deficits were observed after surgery. Computed tomography (CT) on the same day and magnetic resonance imaging (MRI) on the next day revealed no hemorrhage or infarction. The patient had a headache and transit motor aphasia on postoperative day (POD) 8. Arterial spin-labeling magnetic resonance perfusion image on the same day and single photon emission CT scan on POD 10 demonstrated hyperperfusion in the left cerebral cortex. The symptoms gradually improved over a week and she had no new neurological deficits when discharged from hospital.
CONCLUSIONS: This report suggests that, although rare, hyperperfusion syndrome after trapping with high-flow bypass should be considered in giant aneurysmal patients if they present with headache and neurological deficits in a delayed period.
PMID: 29689406 [PubMed - as supplied by publisher]
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