Cortical sulcal effacement on brain CT associated with cerebral hyperperfusion after carotid artery stenting

We present two patients with reversible neurologic deficits after carotid artery stenting. The patients showed diffuse cortical sulcal effacement without parenchymal hypoattenuation on brain non-contrast CT as well as mild hyperperfusion on perfusion imaging. There was no white matter edema or intracerebral hemorrhage in either patient. We speculated that hyperperfusion after carotid artery stenting could be the underlying cause of the cortical sulcal effacement on brain CT in the absence of prominent cytotoxic or vasogenic edema.