Cerebral hyperperfusion syndrome after carotid endarterectomy: case report

Prevention of disability from cerebrovascular accident through carotid endarterectomy, neurovascular stenting, and endovascular treatment of stroke are among the most promising treatments for neurovascular diseases. Cerebral hyperperfusion syndrome is a rare complication of these procedures, and this case report illustrates a patient with this condition after carotid endarterectomy. The mechanism of hyperperfusion is thought to be from chronic compensatory small vessel dilation to maintain cerebral perfusion in the context of vascular stenosis. Treatment is largely supportive with strict blood pressure control. As treatment options for neurovascular reperfusion become mainstay, emergency clinicians need to be appraised to post procedural complications such as cerebral hyperperfusion.