Hyperacute intracerebral hemorrhage complicating carotid stenting should be distinguished from hyperperfusion syndrome.
We describe a patient who experienced a fatal ipsilateral basal ganglia hemorrhage within an hour after carotid angioplasty and stent placement. In the few similar cases published there were no prodromata, but hyperacute onset of severe neurologic deterioration corresponding to intracerebral hemorrhage (ICH). Our findings suggest that besides the delayed ICH that is associated with hyperperfusion syndrome (HPS), a second type of hyperacute and usually fatal ICH exists that resembles hypertensive hemorrhage.
Buhk
J-H
JH
Department of Neuroradiology, University Hospital Goettingen, Robert-Koch-Strasse 40, D-37075 Goettingen, Germany. jh.buhk@med.uni-goettingen.de
Cepek
L
L
Knauth
M
M
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D020145:Basal Ganglia Hemorrhage / Q000209:etiology*; D016893:Carotid Stenosis / Q000628:therapy*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D015607:Stents / Q000009:adverse effects; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D013577:Syndrome