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2017 ; 2017
(ä): 7965758
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Uncommon Etiology for Seizure: Cerebral Hyperperfusion Syndrome
#MMPMID28573058
Kurukumbi M
; Truong A
; Pirsaharkhiz N
Case Rep Neurol Med
2017[]; 2017
(ä): 7965758
PMID28573058
show ga
Cerebral hyperperfusion syndrome (CHS) is a rare life-threatening complication of
carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery
stenosis. The incidence varies between 0 and 3%, depending on the severity of the
stenosis, perioperative hypertension, and contralateral carotid stenosis. This
case report reports a 53-year-old female patient presenting with decreased
alertness and multiple tonic-clonic seizures, in the background of bilateral CEA.
She was found to have bilateral carotid stenosis. Her left CEA was performed
three months prior and right CEA was four days prior to her current presentation
with seizures. After bilateral CEA, the imaging showed extensive pathologic
process involving primarily the subcortical white matter and overlying cortex,
more on the right cerebral hemisphere. On follow-up six weeks later, she reported
no recurrent seizures and imaging showed decrease in abnormal signal intensity of
the grey and white matter. This was indicative of near complete resolution of
hyperperfusion damage. CHS is a rare complication due to the loss of
autoregulation of the cerebrovascular system and increased blood flow status
after bilateral CEA. This case is reported because of a rare and unique
presentation of seizures in the background of bilateral CEA.