Cerebral Hyperperfusion Syndrome following Staged Bilateral Internal Carotid Artery Stenting

Cerebral Hyperperfusion syndrome is a relatively rare event following carotid revascularization. It can occur after both carotid endarterectomy and carotid artery stenting. It is characterized by focal neurodeficit, seizures and headache in the absence of ischemia. It occurs due to ipsilateral cerebral edema secondary to hyperperfusion. CT and MRI of the brain are the main modalities used for diagnosis and to rule out infarct. Prompt recognition and treatment can prevent permanent injury to the brain. We present a case of cerebral hyperperfusion syndrome in an elderly gentleman after a staged bilateral internal carotid artery stenting.