Table 1 Key factors in the pathophysiology of cerebral hyperperfusion syndrome [1, 2, 12–23]
Factor | Pathophysiology |
|---|---|
Impaired auto-regulation and baroreceptor dysfunction | Fluctuations in blood pressure Post-operative hypertension Increase in cerebral perfusion pressure Risk of intracerebral hemorrhage in hypo-perfused tissues Transient bradycardia and changes in cerebral blood flow |
Chronic hypertension, microangiopathy and blood brain barrier | Endothelial dysfunction and microangiopathy Increased vessel permeability Breakdown of blood brain barrier Extravasation of albumin Activation of TGFβ signaling pathways Release of nitric oxide |
Formation of free radicals | Lipid peroxidation Vascular endothelial damage Cerebral edema |
Degree of chronic carotid stenosis | Chronic hypoperfusion Endothelial damage Imbalance of vasodilatory chemicals |
Collateral circulation | Changes in cerebral blood flow Cerebral vasoreactivity |