A Case of Cerebral Hyperperfusion Syndrome during Treatment of Transient Cerebral Vasospasm Following Carotid Artery Stenting

Motoshige Yamashina; Yohei Sato; Mariko Noda; Mayu Sasakawa; Thiparpa Thamamongood; Akihiro Hashizume; Takahiro Ogishima; Masashi Tamaki

doi:10.5797/jnet.cr.2022-0065

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引用する場合も本公開記事を引用してください。

A Case of Cerebral Hyperperfusion Syndrome during Treatment of Transient Cerebral Vasospasm Following Carotid Artery Stenting

Motoshige Yamashina, Yohei Sato, Mariko Noda, Mayu Sasakawa, Thiparpa Thamamongood, Akihiro Hashizume, Takahiro Ogishima, Masashi Tamaki

著者情報

Motoshige Yamashina
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Yohei Sato
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Mariko Noda
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Mayu Sasakawa
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Thiparpa Thamamongood
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Akihiro Hashizume
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Takahiro Ogishima
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan
Masashi Tamaki
Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Tokyo, Japan

キーワード: cerebral vasospasm, carotid artery stenting, selective intra-arterial infusion, hyperperfusion syndrome

ジャーナルオープンアクセス早期公開

論文ID: cr.2022-0065

DOI https://doi.org/10.5797/jnet.cr.2022-0065

この記事には本公開記事があります。

The final version of this article is now available: Vol. 17 (2023), No. 3 pp. 80-87

詳細

抄録

Objective: We report a case in which transient cerebral vasospasm after carotid artery stenting (CAS) was effectively treated using arterial and intravenous infusion of fasudil hydrochloride, but cerebral hyperperfusion syndrome (CHS) developed during subsequent treatment.

Case Presentation: The patient was a 79-year-old man who underwent right CAS to treat symptomatic right carotid artery stenosis. After the procedure, the patient developed left paresis and unilateral spatial neglect. The following day, he developed diffuse cerebral vasospasm in the right middle cerebral artery that improved immediately upon arterial infusion of fasudil hydrochloride. Intravenous infusion of fasudil hydrochloride was then started, but CHS with epileptic seizures developed after 1 day of treatment. After 23 days of medical treatment, the condition of the patient improved to mild hemiparesis.

Conclusion: The present case suggests that transient cerebral vasospasm after CAS may turn into CHS during treatment and that continuous monitoring for cerebral perfusion is important.

責任著者(Corresponding author)

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