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颅内颈内动脉夹层血管重建支架置入术后的脑过度灌注综合征

Cerebral hyperperfusion syndrome after stenting for revascularization of intracranial internal carotid artery dissection.

作者信息

Funatsu Takayuki, Imamura Hirotoshi, Tani Shoichi, Adachi Hidemitsu, Adachi Hiromasa, Sakai Nobuyuki

机构信息

Department of Neurosurgery, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.

Department of Neurosurgery, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.

出版信息

Clin Neurol Neurosurg. 2023 Apr;227:107667. doi: 10.1016/j.clineuro.2023.107667. Epub 2023 Mar 9.

Abstract

Cerebral hyperperfusion syndrome (CHS) is one of the complications of cerebral revascularization. The main pathophysiology of CHS was considered to be cerebral autoregulation impairment due to long-standing cerebral hypoperfusion. Herein, we describe the case of a 40-year-old man with symptomatic intracranial arterial dissection (IAD) related to internal carotid artery stenosis. The patient underwent intracranial stenting 11 days after onset due to severe cerebral hypoperfusion presenting with neurological symptoms, and CHS presenting with intracerebral hemorrhage, post-operatively. The present case indicated not only the potential risk of CHS after intracranial stenting in IAD-related stenosis but also that cerebral hypoperfusion-even in a short period-might lead to CHS.

摘要

脑过度灌注综合征(CHS)是脑血运重建的并发症之一。CHS的主要病理生理学机制被认为是由于长期脑灌注不足导致的脑自动调节功能受损。在此,我们描述了一名40岁男性患者的病例,该患者患有与颈内动脉狭窄相关的症状性颅内动脉夹层(IAD)。患者因出现严重脑灌注不足并伴有神经症状,在发病11天后接受了颅内支架置入术,术后出现CHS并伴有脑出血。本病例不仅提示了IAD相关狭窄患者颅内支架置入术后发生CHS的潜在风险,还表明即使是短期的脑灌注不足也可能导致CHS。

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