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Case No. 753
2026-06-01~2026-06-30
출제자 : 이경미
Hit : 330
| Period | 2026-06-01~2026-06-30 |
|---|---|
| Diagnosis | Cerebral hyperperfusion syndrome |
| Clinical information | C.C> sudden left side weakness after bypass surgery PMHx> Right STA-MCA bypass surgery, underlying moyamoya disease, both. Fig 1. postop. DWI (Sx발생시) Fig 2. postop. perfusion CT (CBF map) |
| Discussion | Rare but severe complication Incidence : around 17% Develop immediately after surgery or up to several weeks later Pathophysiology is not fully understood impaired cerebrovascular autoregulation is considered a key contributing factor Clinical manifestations : severe headache, focal neurological deficits, seizures, and altered consciousness. Radiological findings:patchy or diffuse white matter edema, focal infarction, and petechial hemorrhage ,negative radiological finding cannot exclude CHS. ++CT perfusion: By comparing with the contralateral hemisphere, increase in CBF prediction: increased regional cerebral blood flow and regional cerebral blood volume mean transit time threshold <2s or >4s decreased mean transit time along with decreased time to peak |
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