1. Hyperperfusion syndrome after neck clipping of a ruptured aneurysm on a dolichoectatic middle cerebral artery.
- Author
-
Maruya J, Nishimaki K, and Minakawa T
- Subjects
- Aneurysm, Ruptured complications, Aneurysm, Ruptured diagnosis, Aneurysm, Ruptured physiopathology, Aphasia etiology, Blood Pressure, Cerebral Angiography, Cerebrovascular Disorders diagnosis, Cerebrovascular Disorders physiopathology, Female, Humans, Intracranial Aneurysm complications, Intracranial Aneurysm diagnosis, Intracranial Aneurysm physiopathology, Ligation, Magnetic Resonance Angiography, Middle Cerebral Artery pathology, Middle Cerebral Artery physiopathology, Regional Blood Flow, Subarachnoid Hemorrhage diagnosis, Subarachnoid Hemorrhage etiology, Subarachnoid Hemorrhage physiopathology, Syndrome, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Treatment Outcome, Aneurysm, Ruptured surgery, Cerebrovascular Circulation, Cerebrovascular Disorders etiology, Intracranial Aneurysm surgery, Middle Cerebral Artery surgery, Subarachnoid Hemorrhage surgery, Vascular Surgical Procedures adverse effects
- Abstract
A 40-year-old female presented with sudden onset of severe headache and vomiting due to subarachnoid hemorrhage. Angiography demonstrated a saccular aneurysm on a dolichoectatic left middle cerebral artery (MCA) and delayed filling of the MCA. Magnetic resonance imaging showed a partially thrombosed giant aneurysm on the dolichoectatic MCA. An intentionally delayed operation was performed, during which the neck of the aneurysm was successfully clipped. The patient exhibited aphasia 48 hours after surgery. Single-photon emission computed tomography revealed hyperperfusion in the territory of the left MCA. The patient's blood pressure was maintained normotensively, and her symptoms gradually improved. She returned to work 1 month after surgery. The saccular aneurysm was formed on the dolichoectatic MCA, presumably due to an abnormal arterial wall and hemodynamic stress. The preoperative hypoperfusion might have been caused not only by the giant aneurysm, but also to some degree by the dolichoectatic MCA. After neck clipping, the increase in blood flow might have caused hyperperfusion., (Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF