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Massive non-aneurysmal subarachnoid hemorrhage after cervical carotid angioplasty and stenting: A case report and review of the literature
Neurochirurgie ( IF 1.6 ) Pub Date : 2021-04-22 , DOI: 10.1016/j.neuchi.2021.04.003
A Leclerc 1 , A Goia 2 , V Gilard 2 , S Derrey 2 , S Curey 3
Affiliation  

Introduction

Carotid angioplasty and stenting (CAS) of the cervical segment is a safe and effective procedure for the treatment of carotid artery disease. In rare cases, this procedure causes intracranial hemorrhage (ICH), which is described most often as an ipsilateral intra-parenchymal hematoma. This ICH is the result of a cerebral hyperperfusion syndrome (CHS). Isolated subarachnoid hemorrhage may occur exceptionally, with only 9 cases that have been reported in the literature.

Observation

We reported a case of a 71-year-old man who presented a massive non-aneurysmal subarachnoid hemorrhage one hour after angioplasty and stenting of the cervical segment of the left internal carotid artery. Medical and surgical management included external ventricular drain placement. Rebleeding occurred two days later, worsening the patient's clinical condition. Finally, the patient died 2 weeks later.

Comments

This rare presentation of ICH following CAS allows us to discuss the risk factors, complications and management of CHS.



中文翻译:

颈动脉血管成形术和支架置入术后大量非动脉瘤性蛛网膜下腔出血一例并文献复习

介绍

颈段颈动脉血管成形术和支架置入术(CAS)是治疗颈动脉疾病的一种安全有效的手术方法。在极少数情况下,该手术会导致颅内出血 (ICH),最常被描述为同侧实质内血肿。这种 ICH 是脑高灌注综合征 (CHS) 的结果。孤立性蛛网膜下腔出血可能异常发生,文献报道仅 9 例。

观察

我们报告了一例 71 岁男性,他在左颈内动脉颈段血管成形术和支架置入术后一小时出现大量非动脉瘤性蛛网膜下腔出血。内科和外科治疗包括脑室外引流管放置。两天后发生再出血,使患者的临床状况恶化。最终,患者在 2 周后死亡。

评论

CAS 后这种罕见的 ICH 表现使我们能够讨论 CHS 的危险因素、并发症和管理。

更新日期:2021-04-22
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