Document Detail

Fatal subarachnoid hemorrhage after carotid stenting.
MedLine Citation:
PMID:  15026733     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Cerebral hyperperfusion syndrome with intracerebral hemorrhage (ICH) following carotid angioplasty and stent placement (CAS) of the internal carotid artery (ICA) is well known. We report the occurrence of fatal subarachnoid hemorrhage in a patient undergoing CAS. CASE REPORT: A 77-year-old woman experiencing a left-hemispheric transient ischemic attack underwent CAS for a 95% stenosis of the left ICA. CAS was performed without acute complications. At 5 hours the patient suddenly deteriorated. Her level of consciousness changed and she developed neck stiffness. CT of the brain revealed diffuse SAH with acute hydrocephalus. CONCLUSIONS: Like ICH, SAH may develop as a severe complication after CAS. There are no reliable clinical symptoms preceding this fatal complication. However, several factors such as long-standing severe carotid stenosis with contralateral occlusion and increasing blood pressure after CAS accompanied by the extensive use of antithrombotic agents may predispose to this fatal complication.
M Hartmann; R Weber; S Zoubaa; C Schranz; M Knauth
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neuroradiology. Journal de neuroradiologie     Volume:  31     ISSN:  0150-9861     ISO Abbreviation:  J Neuroradiol     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-03-17     Completed Date:  2004-06-25     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  7705086     Medline TA:  J Neuroradiol     Country:  France    
Other Details:
Languages:  eng     Pagination:  63-6     Citation Subset:  IM    
Division of Neuroradiology, Department of Neurology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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MeSH Terms
Angioplasty, Balloon / adverse effects*
Brain / pathology
Carotid Artery, Internal* / pathology,  radiography
Carotid Stenosis / pathology,  radiography,  therapy*
Cerebral Angiography*
Dominance, Cerebral / physiology
Fatal Outcome
Hydrocephalus / pathology,  radiography
Hyperemia / pathology,  radiography
Intracranial Hypertension / pathology,  radiography
Ischemic Attack, Transient / pathology,  radiography,  therapy
Stents / adverse effects*
Subarachnoid Hemorrhage / pathology,  radiography*
Tomography, X-Ray Computed*

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