title: Bilateral reperfusion injury after carotid endarterectomy with contralateral carotid occlusion.
abstract: Cerebral hyperperfusion syndrome represents a clinical spectrum characterized by severe unilateral headache, acute changes in mental status, vomiting, seizures, focal neurologic deficits, and, in its most severe form, intracranial hemorrhage. With the exception of one early case report, reperfusion injury to the brain following carotid endarterectomy has been reported only ipsilateral to the side of surgery. We report the unique case of a patient with symptomatic severe right internal carotid artery stenosis and contralateral carotid occlusion who underwent carotid endarterectomy complicated by cerebral hyperperfusion syndrome and associated bilateral intracranial hemorrhage.
authors.affiliation: Division of Vascular Surgery, Stanford University, Stanford, USA ullery@gmail.com.
authors.forename: Brant W
authors.initials: BW
authors.lastname: Ullery
authors.affiliation: Department of Surgery, Philadelphia Veterans Affairs Medical Center, Philadelphia, USA.
authors.forename: Venkat
authors.initials: V
authors.lastname: Kalapatapu
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D015427:Reperfusion Injury
keywords: Reperfusion injury; carotid endarterectomy; contralateral carotid occlusion; high risk; hyperperfusion syndrome