[Cause and treatment for intracranial hemorrhage during the perioperative period of carotid artery stenting].
OBJECTIVE
To discuss the possible cause of intracranial hemorrhage and treatment after carotid artery stenting (CAS) in patients with carotid artery stenosis.


METHODS
From January 2003 to August 2009, 403 patients with carotid artery stenosis that were performed CAS, intracranial hemorrhage occurred in 5 cases after the procedure. We analyzed the feature of these cases and perioperative management retrospectively to summarize the possible cause of intracranial hemorrhage and preventive measure.


RESULTS
Cerebral hemorrhage were found 30 min after CAS in 2 cases, 5 days in 2 cases and 3 days in 1 case. One patient was treated conservatively whose hemorrhage was about 2 ml, one was performed draining of ventricle and the other three cases were all performed craniotomy to remove the hematoma and to depress. The position of hemorrhage were all in the side of carotid artery stenosis, and in 2 cases of them the hemorrhage were at the region of previous cerebral infarction. One patient was cured conservatively, the one who was performed draining of ventricle died. Among the other three cases performed craniotomy, one recovered with light neurological deficit and two died of multiple organ failure.


CONCLUSIONS
Intracranial hemorrhage is the most serious complication of CAS of carotid artery, and general measure should be taken to prevent it from occurring.
Li
Sheng
S
Department of Neurosurgery, General Hospital of Chinese People's Liberation Army, Beijing, China. 301lisheng@vip.sina.com
Li
Bao-min
BM
Zhou
Ding-biao
DB
Wang
Jun
J
Cao
Xiang-yu
XY
Liu
Xin-feng
XF
Ge
Ai-li
AL
Zhang
A-lan
AL
D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents