대동맥 양측경동맥 우회로 수술 후 발생한 과관류 증후군 1예

Abstract

Hyperperfusion syndrome is defined as hemispheric neurological deficits occurring after cerebral revascularization without evidence of new infarction, which is localized ipsilateral to the treated artery, not related to thromboembolism. Hyperperfusion syndrome usually develops after carotid endarterectomy or carotid stenting but it has been also reported after other procedures that cause increase of regional cerebral blood flow. A 25-year-old woman was admitted with intermittent postural dizziness. An aortogram revealed complete occlusion of aortic arch vessels. She was diagnosed as Takayasu’s arteritis. Aorto-bicarotid and aorto-biaxillary bypass procedures were performed. After surgery, she had global headache and generalized tonic-clonic seizure. She was diagnosed with hyperperfusion syndrome according to both typical clinical manifestations and the MRI findings. Her symptoms subsided with anti-hypertensive medications. We report a case of hyperperfusion syndrome affecting bilateral cerebral hemispheres after aorto-carotid bypass surgery in a patient with Takayasu’s arteritis.