Cerebral hyperperfusion syndrome

Case contributed by Frank Gaillard
Diagnosis certain


Elderly patient ~6 hours following right carotid endarterectomy developed left-sided weakness.

Patient Data

Age: Elderly
Gender: Male

The right hemisphere demonstrates swollen hyperdense cortex with positive mass effect. No hemorrhage. 

12 hours later


CT scan obtained 12 hours later demonstrates reduced swelling and mass-effect. 

36 hours later


Repeat CT 36 hours later demonstrates almost complete resolution of findings with no evidence of an underlying stroke. 

52 hours later


Yet another repeat study on the third day following carotid endarterectomy demonstrates continued resolution, with at most only minor residual swelling of the right temporal lobe. 

Case Discussion

Cerebral hyperperfusion syndrome is are rare complication of carotid endarterectomy.

The patient made an uneventful recovery. 

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