Suspected Cerebral Hyperperfusion Syndrome after Stenting for Intracranial Vertebral Artery Stenosis Associated with Reduced Cerebral Blood Flow to the Posterior Cerebral Artery Territory

• DOI: 10.5797/jnet.cr.2020-0159
• Publication Date: 2021-01-05T22:10:40Z
• Authors: Masahiro Katsumata; Wataro Tsuruta; Hisayuki Hosoo; Daiichiro Ishigami
• Keywords: Posterior cerebral artery; Carotid stenting

Although several studies have reported on cerebral hyperperfusion syndrome (CHS)/hyperperfusion phenomenon (HPP) involving the anterior circulation after carotid artery stenting (CAS), little is known about CHS/HPP posterior percutaneous transluminal angioplasty (PTA) and of vertebral (VA).A 79-year-old man with chronic occlusion left VA (V4 segment) was admitted to another hospital right-sided hemiplegia, mild disturbance consciousness, dysphagia. A head MRI revealed multiple infarcts in areas, severe stenosis right segment). Single photon emission computed tomography (SPECT) indicated reduced blood flow (CBF) circulation, DSA 76% V4 segment. On day 18, PTA/stenting performed under general anesthesia for VA. However, CT postoperative (POD)1 showed intracranial hemorrhage (ICH) occupying an area measuring 2 cm diameter lobe a small subdural hematoma (SDH). SPECT POD1 increased CBF lobe, we diagnosed CHS might caused ICH. POD4 residual hyperperfusion, POD11 area.Our patient developed ICH undergoing symptomatic territory be one etiologies, prior procedure could risk factor developing PTA/stenting.