Subarachnoid hemorrhage after carotid artery stenting.
We describe subarachnoid hemorrhage (SAH) in a 66-year-old man, who underwent technically successful carotid stenting for a string-stenosis of the right internal carotid artery (ICA) in a presence of contralateral ICA occlusion with recurrent right hemisphere transient ischemic attacks. At 2 hours, the patient developed headache and vomiting, but no focal neurological deficits. Performed transcranial color-coded Doppler (TCCD) showed over 2.8-fold increase of the peak systolic velocity in the right middle cerebral artery. The emergent CT of the brain showed SAH with the right hemisphere edema. Patient was treated with Nimodipine in continuous infusion, diuretics i.v. and additional hypotensive therapy depending on blood pressure values. Clopidogrel was stopped for 5 days. Over next 4 weeks, a gradual cerebral velocities decrease was observed on TCCD, which was related to clinical and CT resolution.
Przewlocki
Tadeusz
T
Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University, Krakow, Poland. tadeuszprzewlocki@op.pl <tadeuszprzewlocki@op.pl>
Pieniazek
Piotr
P
Kablak-Ziembicka
Anna
A
Motyl
Rafal
R
Moczulski
Zbigniew
Z
Tracz
Wieslawa
W
D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications / Q000628:therapy*; D006261:Headache / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D009553:Nimodipine / Q000008:administration & dosage; D015427:Reperfusion Injury / Q000150:complications / Q000209:etiology*; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D017585:Ultrasonography, Doppler, Transcranial; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D009553:Nimodipine