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Fatal Cerebral Reperfusion Hemorrhage after Carotid Stenting Stroke 30:2483-2486, McCabe,D.J.H.,et al, 1999 See this aricle in Pubmed Article Abstract A 68-year-old normotensive man was referred to our hospital for assessment 5 months after experience a left hemispheric ischemic stroke. Angiography confirmed 95% stenosis of the left ICA. Left carotid percutaneous transluminal stenting was performed without any initial complications. Seven hours after the procedure, the patient suddenly deteriorated. CT of the brain revealed extensive intracerebral hemorrhage (ICH), and he subsequently died 18 days later. There was no history of head ache or seizure activity, and this blood pressure was only mildly elevated at the time of the deterioration. This is the first report of ICH after internal carotid stenting. ICH may occur as a hyperperfusion phenomenon after internal carotid stenting, i n the presence of mild to moderate arterial hypertension, without being heralded by any of the typical symptoms of the hyperperfusion syndrome. Patients with increased velocities on color Doppler ultrasound of the ICA after angioplasty should be monitore d closely for features of cerebral hyperperfusion injury. Further studies are warranted to determine whether more aggressive treatment of mild to moderate hypertension after carotid stenting would reduce the likelihood of this potentially fatal complicat ion.

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(click to filter results - removes previous filter) hyperperfusion syndrome iatrogenic neurologic disorders intracerebral hemorrhage mortality neurologic complications of,surgery reperfusion injury stent,carotid artery transluminal angioplasty,carotid artery

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