Parekh M and Silver B
Large clinical trials have established the superiority of carotid endarterectomy for stroke prevention in patients with symptomatic critical carotid artery stenosis. Although postoperative complications are commonly ischemic, cerebral hyperperfusion syndrome represents a rare but potentially treatable diagnosis. Outcomes are contingent on early identification, prevention and management of precipitating factors. Herein, we report the case of a patient who presented with altered mentation, hemiparesis, aphasia and seizures, nine days after left carotid endarterectomy. The underlying pathophysiological mechanism, associated risk factors, screening, prevention and management of cerebral hyperperfusion syndrome are discussed.
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