Document Detail


Cerebral haemorrhage after carotid endarterectomy.
MedLine Citation:
PMID:  8739929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral stroke is a serious complication related to carotid endarterectomy (CEA), being most frequently caused by thromboembolic events and less frequently on account of cerebral haemorrhage. The present series comprised five out of 857 (0.6%) patients who had undergone CEA at Oulu University Hospital between the years 1974 and 1993 and suffered a postoperative stroke four to 13 days after surgery due to intracerebral haemorrhage (IH). Preoperatively, all these patients were neurologically intact, with transient ischaemic attacked (TIA) as the main indication for CEA. All five patients had a history of arterial hypertension treated adequately preoperatively, and one patient had high blood pressure levels after surgery. Critical ipsilateral stenosis of the internal carotid artery (> 90%) was detected in the preoperative angiogram in all five cases. The primary outcome after CEA was uneventful in every case, without any signs of neurological deficiency. The symptoms, comprising severe headache, convulsions and/or hemiparesis occurred suddenly four to 13 days (mean seven days) after CEA. The diagnosis of IH was based on computed tomography (CT) findings. All five patients were treated conservatively. Three of them died. We conclude that even normotensive, neurologically intact patients without demonstrable cerebral infarction or postoperative hypertension may suffer cerebral haemorrhage after the relief of high-grade carotid stenosis. The role of possible insufficiency of the autoregulatory mechanisms of the cerebral vasculature on account of long-standing critical stenosis of the internal carotid artery and subsequent uncontrolled hyperperfusion following CEA are discussed.
Authors:
M Lepojärvi; T Peltola; K Ylönen; T Juvonen; R Pokela; P Kärkölä
Related Documents :
11245069 - Is there any relation between ischemic cerebrovascular disease and extracranial interna...
17204679 - Epsilon pkc may contribute to the protective effect of hypothermia in a rat focal cereb...
11935039 - Risk factors for progression of aortic atheroma in stroke and transient ischemic attack...
10229749 - Usefulness of transcranial color-coded sonography in the diagnosis of cerebral vasospasm.
7247539 - Fibromuscular dysplasia of the internal carotid arteries. clinical experience and follo...
1192359 - Delayed cerebrovascular consequences of therapeutic radiation. a clinicopathologic stud...
24514259 - Tenascin c protects aorta from acute dissection in mice.
6421649 - Effects of nialamide on responses of dog isolated arteries to tyramine and transmural e...
24479719 - Role of α- and β-adrenergic mechanisms in the pathogenesis of pulmonary injuries char...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annales chirurgiae et gynaecologiae     Volume:  85     ISSN:  0355-9521     ISO Abbreviation:  Ann Chir Gynaecol     Publication Date:  1996  
Date Detail:
Created Date:  1996-10-25     Completed Date:  1996-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7609767     Medline TA:  Ann Chir Gynaecol     Country:  FINLAND    
Other Details:
Languages:  eng     Pagination:  23-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Oulu University Hospital, Finland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology
Carotid Artery, Internal / radiography,  surgery
Carotid Stenosis / mortality,  radiography,  surgery*
Cerebral Angiography
Cerebral Hemorrhage / etiology*,  mortality,  radiography
Endarterectomy, Carotid*
Female
Follow-Up Studies
Humans
Ischemic Attack, Transient / etiology,  mortality,  radiography
Male
Middle Aged
Neurologic Examination
Risk Factors
Survival Rate
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effect of dextran infusion on antithrombin III concentrations and on platelet function during mi...
Next Document:  Infrarenal aortofemoral bypass surgery: risk factors and mortality in 330 patients with abdominal ao...