Transcranial Doppler ultrasonography demonstrates that hyperperfusion syndrome after carotid endarterectomy is associated with elevated cerebral flow velocities and low vascular resistance that normalize with symptom improvement.
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Hypothesis-generating for TCD monitoring of post-CEA hyperperfusion; prospective validation required before clinical adoption.
Transcranial Doppler ultrasonography was used to evaluate 2 patients who developed hyperperfusion syndromes after carotid endarterectomy. During the initial postoperative period, each patient had symptoms that were associated with elevated flow velocities in the ipsilateral cerebral vasculature. In addition, vascular resistance of these vessels was found to be abnormally low, as reflected by the Gosling pulsatility index. As the patients' symptoms improved, flow velocities decreased to normal levels and pulsatilities were noted to increase proportionately.
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Powers et al. (1990) studied this question.
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