Carotid stenting and cerebral hyperperfusion syndrome.
We present a patient who became hemiparetic and drowsy 30 min after insertion of a carotid artery stent for severe (>80%) asymptomatic left common carotid artery stenosis. A carotid angiogram at this time showed widely patent vessels. Non-contrast head computed tomography showed a diffuse increase in signal intensity in the distribution of the left middle cerebral artery. Repeat computed tomography 8 days later showed no evidence of cerebral infarction or haemorrhage. The patient's arm remained weak for several months. A diagnosis of cerebral hyperperfusion syndrome was made. The features of this unusual cause of stroke are reviewed.
Geevasinga
Nimeshan
N
University of Sydney, Sydney, New South Wales, Australia. ngeevasi@gmp.usyd.edu.au
Morris
John G L
JG
Ross
David L
DL
D000368:Aged; D016893:Carotid Stenosis / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000150:complications / Q000209:etiology* / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications / Q000209:etiology* / Q000473:pathology; D017023:Coronary Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed