Background: 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.
Conclusion: 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.