# Atypical Hyperperfusion Encephalopathy  in Post-Carotid Stenting

Authors: Nicola Morelli; Gianfranco Cafforio; Simone Gallerini; Michele Puglioli; Alberto Chiti; Filippo Baldacci; Giovanni Orlandi; Luigi Murri; Donata Guidetti
Journal: Scholarly Research Exchange
 (2009)

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## Abstract

Hyperperfusion encephalopathy (HPE) is a condition due to
increased perfusion of the brain which is clinically characterized
by headache, seizures, and other neurologic signs associated with
increased (or not) systemic blood pressures and edema in the
subcortical white matter (predominantly in the occipital lobe).
Patients with critical carotid stenosis treated with
endarterectomy or carotid artery stenting may develop a HPE
syndrome of the ipsilateral hemisphere which closely resembles the
unilateral HPE and that usually involves the vascular area
subjected ipsilaterally to the carotid stenosis. We present here a
case of a 62-year-old woman who developed atypical hyperperfusion
syndrome after a carotid stenting for high-grade carotid artery
stenosis. In our patient, the HPE involved bilaterally both
hemispheres, even though the treatment of the carotid stenosis was
unilaterally. Some authors have hypothesized that a high dose of
contrast, in combination with an unidentified personal
vulnerability, may result in the rupture of the blood-brain
barrier, carrying the CA into the cerebral parenchyma (both
hemispheres), leading to the encephalopathy. The course and
prognosis of HPE in post-carotid stenting are excellent with
conservative treatment and full recovery usually occurs within 24
to 48 hours.


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## Body


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*Source: 108498-2009-06-02.xml*