| Cerebral haemorrhage after carotid endarterectomy. | |
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MedLine Citation:
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PMID: 8739929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Lepojärvi; T Peltola; K Ylönen; T Juvonen; R Pokela; P Kärkölä |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annales chirurgiae et gynaecologiae Volume: 85 ISSN: 0355-9521 ISO Abbreviation: Ann Chir Gynaecol Publication Date: 1996 |
Date Detail:
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Created Date: 1996-10-25 Completed Date: 1996-10-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7609767 Medline TA: Ann Chir Gynaecol Country: FINLAND |
Other Details:
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Languages: eng Pagination: 23-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, Oulu University Hospital, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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