The Cerebral Hyperperfusion Syndrome: Diagnostic Value of Ocular Pneumoplethysmography

Purpose: There were two purposes to our study. The first was to characterize the ocular hyperperfusion associated with carotid endarterectomy. The second was to relate ocular hyperperfusion to the clinical presentation of cerebral hyperperfusion syndrome.

Methods: This was a retrospective chart review of 2331 patients who underwent carotid endarterectomy at our institution between June 1978 and May 1991.

Results: Twelve of these carotid endarterectomies were associated with ocular hyperperfusion on the side of operation. Clinical evidence of cerebral hyperperfusion syndrome was observed in five of these 12 procedures. In these five patients there were two associated fatal intracerebral hemorrhages and one permanent coma. In the latter three patients the contralateral internal carotid arteries were totally occluded.

Conclusion: Ocular hyperperfusion, as documented with ocular pneumoplethysmography, is useful in alerting the physician to the potential for development of the cerebral hyperperfusion syndrome.