Fitas Diogo, Carvalho Marta, Castro Pedro, Abreu Pedro, Moreira Goreti, Santos Rosa, Azevedo Elsa
Department of Neurology, Santa Luzia Hospital, Viana do Castelo, Portugal.
Department of Neurology, São João Hospital Centre, Porto, Portugal.
Pract Neurol. 2018 Oct;18(5):378-381. doi: 10.1136/practneurol-2017-001871. Epub 2018 Jun 6.
Carotid endarterectomy carries the risk of several complications. We report a 55-year-old woman with recurrent cerebral vasoconstriction postoperatively. She had bilateral high-grade internal carotid artery stenosis and underwent right endarterectomy because of transient left-sided sensory symptoms. She developed a reperfusion syndrome with severe right-sided headache, right frontotemporal oedema and increased velocities in transcranial Doppler ultrasound. Given her gradual increase of velocities and Lindegaard index, together with fixed left sensory and motor deficits, we performed CT angiography, which suggested cerebral vasoconstriction syndrome. A subsequent left carotid endarterectomy triggered a similar cerebrovascular response. We highlight the need for continuous monitoring of cerebral haemodynamics following carotid endarterectomy.
颈动脉内膜切除术存在多种并发症风险。我们报告了一名55岁女性，术后出现复发性脑血管收缩。她患有双侧颈内动脉重度狭窄，因短暂性左侧感觉症状接受了右侧内膜切除术。她出现了再灌注综合征，伴有严重的右侧头痛、右额颞部水肿以及经颅多普勒超声检查显示的血流速度增加。鉴于其血流速度和林德加德指数逐渐升高，以及左侧感觉和运动功能持续存在的缺陷，我们进行了CT血管造影，结果提示脑血管收缩综合征。随后进行的左侧颈动脉内膜切除术引发了类似的脑血管反应。我们强调了颈动脉内膜切除术后持续监测脑血流动力学的必要性。
