A case of hyperperfusion syndrome treated successfully by propofol

Carotid endoarterectomy was performed for a 67-year-old male with severe stenosis in the right carotid artery under propofol-fentanyl anesthesia. After the surgery, blood pressure was controlled by sodium nitroprusside to maintain at the preoperative level. On the first postoperative day, he was alert and without neurological deficit, but he became restless with the left hemiparesis appearing on the next day. ECD-SPECT revealed hyperperfusion of the right hemisphere. Propofol was administered at the dose of 3-5 mg · kg^-1 · h^-1 to normalize the perfusion. It appears that the cerebral blood flow was normalized. Hyperperfusion after carotid endoarterectomy can be controlled by propofol.