Epileptic Seizures Attributed to Cerebral Hyperperfusion after Percutaneous Transluminal Angioplasty and Stenting of the Internal Carotid Artery
| Autor: | Michele Chui, Yan Wang, Shu-Leong Ho, Raymond T.F. Cheung, David Sai Wah Ho |
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| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous endocrine system diseases medicine.medical_treatment Carotid endarterectomy Transluminal Angioplasty Postoperative Complications Seizures Angioplasty Internal medicine medicine.artery medicine Humans Carotid Stenosis neoplasms Aged Aged 80 and over Epilepsy business.industry Angiography digestive system diseases Neurology Cerebrovascular Circulation Cardiology Female Stents Neurology (clinical) Internal carotid artery Cardiology and Cardiovascular Medicine business Complication Angioplasty Balloon Carotid Artery Internal |
| Zdroj: | Cerebrovascular Diseases. 10:374-379 |
| ISSN: | 1421-9786 1015-9770 |
| DOI: | 10.1159/000016093 |
| Popis: | Cerebral hyperperfusion syndrome as a complication of carotid endarterectomy (CEA) has been widely reported in the surgical literature. It may occur within hours to 3 weeks after CEA and is characterized by symptoms ranging from headaches, fits, confusion, focal neurological signs to intracerebral hemorrhage. Although percutaneous transluminal angioplasty (PTA) and stenting are increasingly performed as an alternative to CEA in the treatment of carotid artery stenosis, few cases of cerebral hyperperfusion injury following carotid stenting have been reported. We describe 2 cases of cerebral hyperperfusion syndrome following PTA and stenting for high-grade internal carotid artery (ICA) stenosis. Both cases involved a lesion of 95% in severity. The first case was a 73-year-old man who developed generalized convulsion 7 h following stenting to the left ICA. The second case was an 80-year-old woman who developed recurrent right periorbital headache and confusion 16 h after stenting to the right ICA, followed by left upper limb seizure 14 days later. Both patients fully recovered without any intracerebral hemorrhage or infarction. To our knowledge, this is the first report of cerebral hyperperfusion injury after carotid stenting without associated intracranial hemorrhage and with full recovery. In the patient with neurological symptoms following carotid stenting, it is important to consider cerebral hyperperfusion syndrome as a differential diagnosis to embolic or hemorrhagic stroke since early recognition and meticulous control of blood pressure may prevent progression to cerebral hemorrhage and death. |
| Databáze: | OpenAIRE |
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