Yoshimoto T, Itou T, Takikawa S, Horiuchi N
Department of Neurosurgery, Nikkou Memorial Hospital, Hokkaido.
Neurol Med Chir (Tokyo). 1991 Dec;31(13):961-5. doi: 10.2176/nmc.31.961.
Recently attention has been drawn to postoperative cerebral hyperperfusion after carotid endarterectomy (CEA) associated with a preoperative state of impaired cerebral hemodynamics. Rarely postoperative neurological deficits are caused by cerebral edema due to hyperperfusion. The patient was a 65-year-old male with dysarthria and right hemiparesis. Because of the presence of severe stenosis of the left carotid artery, CEA was performed. On the 6th postoperative day, he developed severe right hemiparesis and aphasia due to cerebral edema in the subcortical region of the left cerebral hemisphere. Left carotid angiography showed normal circulation without evidence of the carotid stenosis. Later the cerebral edema and the neurological deficits gradually disappeared.
最近,颈动脉内膜切除术(CEA)术后脑血流灌注过多受到关注,其与术前脑血流动力学受损状态相关。术后因灌注过多导致脑水肿而引起的神经功能缺损极为罕见。该患者为一名65岁男性,有构音障碍和右侧偏瘫。由于左侧颈动脉存在严重狭窄,遂行CEA。术后第6天,他因左侧大脑半球皮质下区域脑水肿出现严重右侧偏瘫和失语。左侧颈动脉血管造影显示循环正常,无颈动脉狭窄迹象。后来脑水肿和神经功能缺损逐渐消失。