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Ischemic stroke
Cerebral hyperperfusion syndrome after mechanical thrombectomy
  1. Markus Kneihsl1,
  2. Christian Enzinger1,2,
  3. Thomas Gattringer1,2
  1. 1 Department of Neurology, Medical University of Graz, Graz, Austria
  2. 2 Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Markus Kneihsl, Department of Neurology, Medical University of Graz, Graz 8036, Austria; markus.kneihsl{at}medunigraz.at

https://doi.org/10.1136/neurintsurg-2021-017693

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    Case summary

    A male patient in his late 50s who had untreated atrial fibrillation received mechanical thrombectomy for right middle cerebral artery occlusion (MCA), with complete recanalization. After initial neurological improvement, he developed headache and altered vigilance 2 days post-thrombectomy. Transcranial duplex sonography (TCD) showed increased blood flow velocities in the entire ipsilateral (recanalized) MCA-M1 segment.1 2 Brain MRI with angiography excluded focal stenosis and showed vasogenic edema, hemorrhagic transformation of the ischemic infarct, and cerebral hyperperfusion in the right MCA territory (figure 1). Because of this finding, the patient underwent intense blood pressure (BP) control (systolic BP target …

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    Footnotes

    • Contributors MK: case report design, acquisition and interpretation of data, manuscript preparation. CE: critical revision of the manuscript content. TG: case report concept and design, interpretation of data, manuscript preparation, critical revision of the manuscript content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.