神戸大学附属図書館デジタルアーカイブ
https://hdl.handle.net/20.500.14094/90008502

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メタデータID
90008502
アクセス権
open access
出版タイプ
Version of Record
タイトル
Subarachnoid hemorrhage associated with cerebral hyperperfusion syndrome after simultaneous carotid endarterectomy and coronary artery bypass grafting procedures: A case report and review of the literature
著者
Miura, Shinichi ; Imahori, Taichiro ; Sugihara, Masahiro ; Mizobe, Takashi ; Aihara, Hideo ; Fukase, Keigo ; Matsumori, Masamichi ; Murakami, Hirohisa ; Hosoda, Kohkichi ; Sasayama, Takashi ; Kohmura, Eiji
著者名
Miura, Shinichi
著者ID
A2355
研究者ID
1000030604277
著者名
Imahori, Taichiro
今堀, 太一郎
イマホリ, タイチロウ
所属機関名
医学部附属病院
著者名
Sugihara, Masahiro
著者名
Mizobe, Takashi
著者名
Aihara, Hideo
著者名
Fukase, Keigo
著者名
Matsumori, Masamichi
著者名
Murakami, Hirohisa
著者名
Hosoda, Kohkichi
著者ID
A1382
研究者ID
1000010379399
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=b8758a4d12d875ed520e17560c007669
著者名
Sasayama, Takashi
篠山, 隆司
ササヤマ, タカシ
所属機関名
医学研究科
著者ID
A0460
研究者ID
1000030225388
著者名
Kohmura, Eiji
甲村, 英二
コウムラ, エイジ
所属機関名
医学研究科
言語
English (英語)
収録物名
Interdisciplinary Neurosurgery
巻(号)
25
ページ
101144
出版者
Elsevier B.V.
刊行日
2021-09
公開日
2021-08-12
抄録
Background: Intracranial hemorrhage associated with cerebral hyperperfusion syndrome (CHS) is a potentially devastating complication of carotid endarterectomy (CEA) or carotid artery stenting. Intracranial hemorrhage can comprise of intracerebral hemorrhage or subarachnoid hemorrhage (SAH), but SAH after CEA is rare. We report a case of SAH associated with CHS that followed simultaneous CEA and coronary artery bypass grafting (CABG). Case description: A 78-year-old man developed left-sided hemiparesis and was admitted to our institution. A preoperative study showed severe stenosis of the right carotid artery associated with markedly reduced cerebral blood flow (CBF), and a CEA was scheduled after initiating medical treatment. However, the patient developed unstable angina requiring an emergency CABG before undergoing an elective CEA. Given the risk of stroke associated with performing CABG alone, simultaneous CEA and CABG were urgently performed. The patient received dual antiplatelet therapy preoperatively and anticoagulation intraoperatively for the CABG procedure, and the anticoagulation was continued postoperatively due to the development of atrial fibrillation. Three days after the surgery, the patient developed a headache and magnetic resonance imaging demonstrated right-sided cortical SAH. Single-photon emission computed tomography revealed a significantly increased CBF. Therefore, the SAH appears to have been associated with CHS after the CEA. The hemorrhage was managed conservatively and resolved without an associated neurological deficit. Conclusion: SAH after CEA is rare clinical manifestation of CHS. Simultaneous CEA and CABG, or aggressive perioperative antithrombotic therapy, may increase the risk of its occurrence. Early diagnosis and careful management are important for favorable outcomes.
キーワード
Subarachnoid hemorrhage
Intracranial hemorrhage
Cerebral hyperperfusion syndrome
Carotid artery stenosis
Carotid endarterectomy
Carotid artery stenting
Coronary artery bypass grafting
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
権利
© 2021 The Author(s). Published by Elsevier B.V.
CC license
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
関連情報
DOI
https://doi.org/10.1016/j.inat.2021.101144