Massive non-aneurysmal subarachnoid hemorrhage after cervical carotid angioplasty and stenting: A case report and review of the literature |
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| Affiliation: | 1. CHU de Caen, Department of Neurosurgery, Avenue de la Côte de Nacre, 14000 Caen, France;2. CHU de Rouen, Department of Neurosurgery, 76000 Rouen, France;3. Université Caen Normandie, Medical School, 14000 Caen, France;4. Université Rouen Normandie, Medical School, 76000 Rouen, France;1. Service de neurochirurgie, hôpital Pasteur 2, CHU de Nice, 30, avenue de la voie romaine, 06000 Nice, France;2. Université Côte d’Azur, Nice, France;3. Service d’ophtalmologie, hôpital Pasteur 2, Nice, France;4. Centre de ressources et de compétences Sclérose en Plaques (CRCSEP), hôpital Pasteur 2, Nice, France;5. Service d’ORL, IUFC, Nice, France;6. Service de radiologie, hôpital Pasteur 2, Nice, France;1. Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France;2. Department of Neurology, Rothschild Ophthalmologic Foundation, Paris, France;3. Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France;4. Department of Neurosurgery, Beaujon Hospital, Clichy, France;5. CNRS UMR7622 Sorbonne Université, Inserm ERL U1156, Paris, France;1. Hôpital privé de la Loire, Ramsay Santé, 39, boulevard de la Palle, 42100 Saint-Étienne, France;2. University Claude-Bernard, Lyon 1, France;3. Regional reference center for complex bone and joint infections (CRIOAc Lyon), hospices civils de Lyon, Lyon, France;1. Neurosurgery University Hospital Reims, 45, rue de Cognacq Jay, 51092 Reims, France;2. Endocrinology University Hospital Reims, Reims, France |
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| Abstract: | ![]()
IntroductionCarotid 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.ObservationWe 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.CommentsThis rare presentation of ICH following CAS allows us to discuss the risk factors, complications and management of CHS. |
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