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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:1508-1513, August 2006
© 2006 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Hyperacute Intracerebral Hemorrhage Complicating Carotid Stenting Should Be Distinguished from Hyperperfusion Syndrome

J.-H. Buhk^a, L. Cepek^b and M. Knauth^a

^a Department of Neuroradiology, University Hospital Goettingen, Germany
^b Department of Neurology, University Hospital Goettingen, Germany

Address correspondence to Jan-Hendrik Buhk, MD, Department of Neuroradiology, University Hospital Goettingen, Robert-Koch-Str. 40, Goettingen, D-37075, Germany; e-mail: jh.buhk{at}med.uni-goettingen.de

SUMMARY: We describe a patient who experienced a fatal ipsilateral basal ganglia hemorrhage within an hour after carotid angioplasty and stent placement. In the few similar cases published there were no prodromata, but hyperacute onset of severe neurologic deterioration corresponding to intracerebral hemorrhage (ICH). Our findings suggest that besides the delayed ICH that is associated with hyperperfusion syndrome (HPS), a second type of hyperacute and usually fatal ICH exists that resembles hypertensive hemorrhage.