Q: What is cerebral hyperperfusion syndrome?
Answer: After carotid artery stenting or carotid endarterectomy (CEA), patient may experience headache on the ipsilateral side of the procedure, which usually improved in upright posture due to gravity. If it continues, patient may develop seizure or even Intra-Cerebral hemorrhage (ICH). The best prevention is blood pressure control.
Mechanism of action: Due to long standing carotid stenosis prior to surgery small vessels in the brain compensate with dilatation. Resolution of carotid stenosis leads to elevated perfusion pressure as there is a chronic loss of cerebral blood flow autoregulation.
This again emphasis the need of keeping Systolic
Blood Pressure less than 140 mm Hg post carotid intervention.
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