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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Kim, Kyung Hyun (Department of Neurosurgery, Seoul National University Hospital) Lee, Chang-Hyun (Department of Neurosurgery, Seoul National University Bundang Hospital) Son, Young-Je (Department of Neurosurgery, SMG-SNU Boramae Medical Center) Yang, Hee-Jin (Department of Neurosurgery, SMG-SNU Boramae Medical Center) Chung, Young Sub (Department of Neurosurgery, SMG-SNU Boramae Medical Center) Lee, Sang Hyung (Department of Neurosurgery, SMG-SNU Boramae Medical Center)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제54권 제3호
발행연도
2013.1
수록면
159 - 163 (5page)

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Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.
#Carotid endarterectomy #Hyperperfusion #Cerebral blood flow #Blood pressure #Cerebral hyperperfusion syndrome

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참고문헌 (34)

참고문헌 신청
Abou-Chebl A / 2007 / Intensive treatment of hypertension decreases the risk of hyperperfusion and intracerebral hemorrhage following carotid artery stenting / Catheter Cardiovasc Interv 69:690~696 google schola Adhiyaman V / 2007 / Cerebral hyperperfusion syndrome following carotid endarterectomy / QJM 100:239~244 google schola Bernstein M / 1984 / Cerebral hyperperfusion after carotid endarterectomy : a cause of cerebral hemorrhage / Neurosurgery 15:50~56 google schola Biller J / 1998 / Guidelines for carotid endarterectomy : a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association / Stroke 29:554~562 google schola Bouri S / 2011 / Hypertension and the post-carotid endarterectomy cerebral hyperperfusion syndrome / Eur J Vasc Endovasc Surg 41:229~237 google schola

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