A case of cerebral hyperperfusion following spontaneous recanalization of occluded middle cerebral artery: Reperfusion injury or true cerebral hyperperfusion syndrome?

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Cerebral hyperperfusion syndrome (CHS) and reperfusion injury are distinct pathological phenomena.

Case summary:

We present the case of a young ischemic stroke patient with middle cerebral artery (MCA) occlusion and spontaneous recanalization. Follow-up transcranial Doppler ultrasound showed high velocity flow in the left MCA, and neuroimaging revealed infarction, brain edema, artery dilatation, and hyperperfusion, consistent with both CHS and reperfusion injury.


In cases with signs of both CHS and reperfusion injury, we speculate that CHS may be both a contributor to and a manifestation of reperfusion injury.

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