Prolonged and regionally progressive symptomatic cerebral hyperperfusion syndrome after superficial temporal artery-middle cerebral artery anastomosis in a patient with moyamoya disease
Open Access
- 1 January 2012
- journal article
- Published by Scientific Scholar in Surgical Neurology International
- Vol. 3 (1), 106
- https://doi.org/10.4103/2152-7806.100867
Abstract
The incidence of symptomatic hyperperfusion syndrome after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis for patients with moyamoya disease (MMD) approaches 30%. In most cases, hyperperfusion occurs in a localized area and disappears within 1-2 weeks. A 59-year-old female diagnosed with asymptomatic MMD for 4 months became rapidly symptomatic with transient ischemic attacks (TIAs). After left STA-MCA anastomosis surgery, she developed symptomatic hyperperfusion, initially (1-2 weeks after surgery) manifesting with severe headache and lesions located in the left basal ganglia. She then developed (2-5 weeks after surgery) aphasia and right hemiparesis caused by new hyperperfusion lesions located in the left frontal area. At discharge (7 weeks after surgery), she recovered fully without any remaining neurologic deficit and no ischemic lesions. This report details a rare case of a patient with MMD who presented with regionally progressive hyperperfusion lesions after STA-MCA anastomosis and symptoms that persisted for 5 weeks following surgery. Results from this case suggest that regional differences exist in the functional recovery of cerebrovascular reactivity (CVR) in a patient with rapidly progressive MMD.Keywords
This publication has 23 references indexed in Scilit:
- Significance of Focal Cerebral Hyperperfusion as a Cause of Transient Neurologic Deterioration After Extracranial-Intracranial Bypass for Moyamoya Disease: Comparative Study With Non-Moyamoya Patients Using N-Isopropyl-p-[123I]Iodoamphetamine Single-Photon Emission Computed TomographyNeurosurgery, 2011
- Moyamoya Disease: Recent Progress and OutlookNeurologia medico-chirurgica, 2010
- Clinical implications of intraoperative infrared brain surface monitoring during superficial temporal artery–middle cerebral artery anastomosis in patients with moyamoya diseaseJournal of Neurosurgery, 2009
- Cerebral hyperperfusion syndromeThe Lancet Neurology, 2005
- Prediction and monitoring of cerebral hyperperfusion after carotid endarterectomy by using single-photon emission computerized tomography scanningJournal of Neurosurgery, 2003
- Effectiveness of Superficial Temporal Artery–Middle Cerebral Artery Anastomosis in Adult Moyamoya DiseaseStroke, 1998
- Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease.Stroke, 1997
- Intracerebral hemorrhage after carotid endarterectomyJournal of Neurosurgery, 1988
- CORRELATION OF CEREBRAL BLOOD-FLOW AND ELECTROENCEPHALOGRAPHIC CHANGES DURING CAROTID ENDARTERECTOMY - WITH RESULTS OF SURGERY AND HEMODYNAMICS OF CEREBRAL-ISCHEMIA1981
- Cerebrovascular "Moyamoya" DiseaseArchives of Neurology, 1969