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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Cerebral hyperperfusion syndrome (CHS)
Synonyms
- Post-CEA hyperperfusion
- Luxury perfusion
Definitions
- Rare (3.5%) disorder most commonly occurring as complication of cerebral revascularization
- Mildly ↑ cerebral blood flow (CBF) common after carotid endarterectomy (CEA), typically asymptomatic
- CHS defined as ≥ 100% increase in rCBF compared to preoperative values
- Major increase in ipsilateral CBF well above normal metabolic demands
- Usually following carotid revascularization procedure
- Carotid endarterectomy
- Angioplasty with stenting
- Thrombolysis
- May occur in other settings [e.g., status epilepticus, mitochondrial encephalopathy lactic acidosis and stroke-like episodes (MELAS)]
- After drainage of chronic subdural hematomas
- Usually following carotid revascularization procedure
- Rare (3.5%) disorder most commonly occurring as complication of cerebral revascularization
IMAGING
General Features
Angiographic Findings
Imaging Recommendations
CT Findings
MR Findings
Other Modality Findings
Ultrasonographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Lin YH et al: Update on cerebral hyperperfusion syndrome. J Neurointerv Surg. ePub, 2020
- Murai S et al: Safety and efficacy of staged angioplasty for patients at risk of hyperperfusion syndrome: a single-center retrospective study. Neuroradiology. 62(4):503-10, 2020
- Pavlov O: Rapid evacuation of chronic subdural hematoma - A possible traumatic brain injury (TBI). Med Hypotheses. 137:109539, 2020
- Sakata H et al: Symptomatic cerebral hyperperfusion after cerebral vasospasm associated with aneurysmal subarachnoid hemorrhage. World Neurosurg. 137:379-83, 2020
- Fassaert LMM et al: Transcranial Doppler 24 hours after carotid endarterectomy accurately identifies patients not at risk of cerebral hyperperfusion syndrome. Eur J Vasc Endovasc Surg. 58(3):320-7, 2019
- Ghuman M et al: Sentinel angiographic signs of cerebral hyperperfusion after angioplasty and stenting of intracranial atherosclerotic stenosis: A technical note. AJNR Am J Neuroradiol. 40(9):1523-5, 2019
- Lin T et al: ASL perfusion features and type of circle of Willis as imaging markers for cerebral hyperperfusion after carotid revascularization: a preliminary study. Eur Radiol. 29(5):2651-8, 2019
- Omura T et al: Cerebral hyperperfusion syndrome after a burr hole drainage surgery for chronic subdural hematoma. World Neurosurg. ePub, 2019
- Sharma P et al: Cerebral hyperperfusion syndrome after chronic subdural hematoma drainage. World Neurosurg. 126:694, 2019
- Huibers AE et al: Editor's choice - Cerebral hyperperfusion syndrome after carotid artery stenting: A systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 56(3):322-33, 2018
- Kirchoff-Torres KF et al: Cerebral hyperperfusion syndrome after carotid revascularization and acute ischemic stroke. Curr Pain Headache Rep. 22(4):24, 2018
- Galyfos G et al: Cerebral hyperperfusion syndrome and intracranial hemorrhage after carotid endarterectomy or carotid stenting: A meta-analysis. J Neurol Sci. 381:74-82, 2017
- Cano EJ et al: Asymmetric brain edema after cardiac transplantation: cerebroautoregulatory failure and relative hyperperfusion. Transplant Proc. 47(1):194-7, 2015
- Horie N et al: De novo ivy sign indicates postoperative hyperperfusion in moyamoya disease. Stroke. 45(5):1488-91, 2014
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Cerebral hyperperfusion syndrome (CHS)
Synonyms
- Post-CEA hyperperfusion
- Luxury perfusion
Definitions
- Rare (3.5%) disorder most commonly occurring as complication of cerebral revascularization
- Mildly ↑ cerebral blood flow (CBF) common after carotid endarterectomy (CEA), typically asymptomatic
- CHS defined as ≥ 100% increase in rCBF compared to preoperative values
- Major increase in ipsilateral CBF well above normal metabolic demands
- Usually following carotid revascularization procedure
- Carotid endarterectomy
- Angioplasty with stenting
- Thrombolysis
- May occur in other settings [e.g., status epilepticus, mitochondrial encephalopathy lactic acidosis and stroke-like episodes (MELAS)]
- After drainage of chronic subdural hematomas
- Usually following carotid revascularization procedure
- Rare (3.5%) disorder most commonly occurring as complication of cerebral revascularization
IMAGING
General Features
Angiographic Findings
Imaging Recommendations
CT Findings
MR Findings
Other Modality Findings
Ultrasonographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Lin YH et al: Update on cerebral hyperperfusion syndrome. J Neurointerv Surg. ePub, 2020
- Murai S et al: Safety and efficacy of staged angioplasty for patients at risk of hyperperfusion syndrome: a single-center retrospective study. Neuroradiology. 62(4):503-10, 2020
- Pavlov O: Rapid evacuation of chronic subdural hematoma - A possible traumatic brain injury (TBI). Med Hypotheses. 137:109539, 2020
- Sakata H et al: Symptomatic cerebral hyperperfusion after cerebral vasospasm associated with aneurysmal subarachnoid hemorrhage. World Neurosurg. 137:379-83, 2020
- Fassaert LMM et al: Transcranial Doppler 24 hours after carotid endarterectomy accurately identifies patients not at risk of cerebral hyperperfusion syndrome. Eur J Vasc Endovasc Surg. 58(3):320-7, 2019
- Ghuman M et al: Sentinel angiographic signs of cerebral hyperperfusion after angioplasty and stenting of intracranial atherosclerotic stenosis: A technical note. AJNR Am J Neuroradiol. 40(9):1523-5, 2019
- Lin T et al: ASL perfusion features and type of circle of Willis as imaging markers for cerebral hyperperfusion after carotid revascularization: a preliminary study. Eur Radiol. 29(5):2651-8, 2019
- Omura T et al: Cerebral hyperperfusion syndrome after a burr hole drainage surgery for chronic subdural hematoma. World Neurosurg. ePub, 2019
- Sharma P et al: Cerebral hyperperfusion syndrome after chronic subdural hematoma drainage. World Neurosurg. 126:694, 2019
- Huibers AE et al: Editor's choice - Cerebral hyperperfusion syndrome after carotid artery stenting: A systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 56(3):322-33, 2018
- Kirchoff-Torres KF et al: Cerebral hyperperfusion syndrome after carotid revascularization and acute ischemic stroke. Curr Pain Headache Rep. 22(4):24, 2018
- Galyfos G et al: Cerebral hyperperfusion syndrome and intracranial hemorrhage after carotid endarterectomy or carotid stenting: A meta-analysis. J Neurol Sci. 381:74-82, 2017
- Cano EJ et al: Asymmetric brain edema after cardiac transplantation: cerebroautoregulatory failure and relative hyperperfusion. Transplant Proc. 47(1):194-7, 2015
- Horie N et al: De novo ivy sign indicates postoperative hyperperfusion in moyamoya disease. Stroke. 45(5):1488-91, 2014
