C114 Parenchymal bleed, sdh and sah following carotid stenting

<h3>Introduction</h3> Reperfusion syndrome following revascularisation of chronically stenosed carotid is a rare entity. High mortality and morbidity are carried by intracranial bleed following carotid stent. Managing of intracranial bleed in post stenting patient is still a challange. Would like to present a case with parenchymal bleed, SAH and SDH following carotid stent in a criticall stenosed carotid artery. Patient was managed conservatively and discharged in a good clincal condition. <h3>Case Description</h3> A 65 year old- lady, presented to the emergency department with history of left sided weakness for the last 16 hours. MRi brain used for evaluation, which revealed right sided water shed infarct with right ICA stenosis at origin. A cerebral angiogram confirmed critical stenosis of ICA. Clinical team planned carotid stent for her after optimisation. Carotid stent (Acculink-6x8x40mm) was placed accross the stenosis. She experienced transient episode of shivering and hypertension. Hypertension managed with Labetolol stat and NTG infusion. The following day, she complaned of right sided headache but showed no fresh neurologic deficits. Brain imaging revealed a right temporal bleed, right parietal SDH, and right parieto-occipital SAH without mass effect. The medical team closely monitored her condition with strict blood pressure control, ensuring no neurological deterioration, and maintained her on low- dose single antiplatelet regimen. <h3>Conclusions</h3> Strict blood pressure control and the judicoius use of antiplatelet regime are the crucial steps in the managament intracranial bleed immediately after carotid stent placement. <h3>Conflict of Interest</h3> No