Neuroimaging patterns of cerebral hyperperfusion

3rd International Conference and Young Scientist School "Magnetic resonance imaging in biomedical research"

物理学;医药卫生

Semenov, S.^1 ; Portnov, Yu^1 ; Semenov, A.^2 ; Korotkevich, A.^1 ; Kokov, A.^1

Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia^1

Praxis Wolfgang Theobald Facharzt für Radiologie, Saarlouis, Saarland, Germany^2

关键词: Cardiac ischemia;    Coronary artery bypass surgery;    Ischemic strokes;    Neurological symptoms;    Perfusion-ct;    Predisposing factors;    Revascularization;    Venous stasis;   

Others  :  https://iopscience.iop.org/article/10.1088/1742-6596/886/1/012014/pdf
DOI  :  10.1088/1742-6596/886/1/012014

学科分类：卫生学

来源: IOP

【 摘 要 】

Cerebral hyperperfusion syndrome (CHS) after revascularization is a rare phenomenon associated with post-ischemic (reactive) hyperemia and acute pathological hyperperfusion. First described on perfusion CT as a very often moderate CBF increase, MTT/TTP decrease within 30% like a temporary effect, according to a short-time deterioration of neurological symptoms (vestibular ataxia - 58%, vegetative dysfunction - 100%, asthenic syndrome - 100%) in early postoperative period in patients with cardiac ischemia who had undergone coronary artery bypass surgery. The acute pathological hyperperfusion carotid revascularization is a casuistic phenomenon with two- or three-fold CBV and MTT/TTP increase and high hemorrhage risk. Besides, we detected similar exchanges via perfusion CT called benign hyperemia, which marks extension of MTT/TTP and an increase of CBV from 27% to 48% (average 30%), but with normal CBF-parameters, indicating that venous stasis in acute venous ischemic stroke due cerebral venous sinus-trombosis (68%), only 6% in cardioembolic stroke and appears never in arterial stroke. Territorial coincidence registered for perifocal of necrosis zones of benign hyperemia and vasogenic edema accompanied on MRI (DWI, ADC). Secondary hemorrhagic transformation registered for primary non-hemorrhagic venous stroke in 27%, only in 9% for arterial stroke and in 60% for cardioembolic stroke. Probably, congestion is an increasingly predisposing factor secondary hemorrhaging than necrosis.