Cerebral Hyperperfusion syndrome after the middle cerebral artery angioplasty with WingSpanTM stent

초록

Background Cerebral hyperperfusion syndrome(CHS) is known as a complication of carotid angioplasty with stent. However, CHS after angioplasty of intracranial stenosis remained still unknown. We experienced one case of CHS after angioplasty of middle cerebral artery stenosis, using WingSpan® stent. Case Report A 67-year-old female was admitted with dysarthria. Brain magnetic resonance(MR) images and digital subtraction angiography indicated acute cerebral infarction with severe stenosis of right middle cerebral artery(MCA). Four days after angioplasty of right MCA using WingSpanTM stent, drowsy mentality and persisted generalized tonic-clonic seizure suddenly developed. Follow-up MR perfusion and Diffusion weighted images showed hyperperfusion state with vasogenic edema. She recovered, six weeks after antiepileptic drug medication and blood pressure control without CHS-related persistent sequelae. Conclusion To our knowledge, this is the first case of CHS after MCA angioplasty. Close observation should be considered over 4 days after angioplasty of intracranial artery stenosis.