WJCD  Vol.3 No.3 , June 2013
Retinal hemorrhage as a unique ophthalmic manifestation of cerebral hyper perfusion syndrome

Cerebral hyperperfusion syndrome (CHPS) is a rare disease with complications of carotid artery revascularization. Acute retinal hemorrhage is a very rare entity that has been previously described as a manifestation of CHPS followed by the carotid artery stenting (CAS), but to the best of our knowledge, not yet described as a complication of carotid surgery. An Ascending Aorta to bilateral Carotid bypass was performed in a 35 years old woman with active Takayasu arteritis and 95% symptomatic stenosis of both common carotid arteries. Severe retinal hemorrhage appeared on the second post operative day combined with high blood pressure, brain edema on CT scan and grand mal seizures. It seems that fundoscopic examination followed by the carotid revascularization of tightness can be helpful in identifying those patients who develop symptoms suggesting of CHPS.

Cite this paper
Heldenberg, E. and Bass, A. (2013) Retinal hemorrhage as a unique ophthalmic manifestation of cerebral hyper perfusion syndrome. World Journal of Cardiovascular Diseases, 3, 287-289. doi: 10.4236/wjcd.2013.33045.
[1]   Sundt, T.M., Sharbourgh, F.W., Piepgras, D.G., Kearns, T.P., Messick, J.M., O’Fallon, W.M. (1987) Correlation of cerebral blood flow and electroencephalographic changes during Endarterectomy: With results of surgery and hemodynamic of cerebral ischemia. Mayo Clinic Proceedings, 56, 533-543.

[2]   Ogasawara, K., Mikami, C., Inoue, T. and Ogawa, A. (2004) Delayed cerebral hyperperfusion syndrome caused by prolonged impairment of cerebrovascular auto regulation after carotid end arterectomy: Case report. Neurosurgery, 54, 1258-1262. doi:10.1227/01.NEU.0000120064.55339.F9

[3]   Krapanayiotides, T., Meuli, R., Devuyst, G., Piechowski, Jozwiak, B., Dewarrat, A., Ruchat, P., Segger, V.L. and Bogousslasky, J. (2005) Post carotid endarterectomy hyperperfusion or reperfusion syndrome. Stroke, 6, 21-36.

[4]   Nicholas, G.G., Hashemi, H., Gee, W. and Reed, F.J. (1993) The cerebral hyperperfusion syndrome: Diagnostic value of ocular pneumoplethysmography. Journal of Vascular Surgery, 17, 690-695. doi:10.1016/0741-5214(93)90112-Y

[5]   Kim, D.Y., Kim, B.M., Park, H. and Chung, J. (2011) Retinal hemorrhage as an initial sign of cerebral hyperperfusion Syndrome after carotid artery stenting. Acta Neurochirurgica, 154, 75-77. doi:10.1007/s00701-011-1194-z

[6]   Do, D.V., Rismondo, V. and Nyguyen, Q.D. (2002) Reversible cortical blindness in preeclampsia. American Journal of Ophthalmology, 134, 916-918. doi:10.1016/S0002-9394(02)01753-1