David T Asuzu1, Jeyan Kumar2, Stepan Capek2, Min S Park3. 1. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA; Surgical Neurology Branch, National Institutes of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, Maryland, USA. 2. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA. 3. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA. Electronic address: MP2TQ@hscmail.mcc.virginia.edu.
Abstract
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare complication after carotid endarterectomy (CEA). Only a limited number of prior cases of RCVS have been reported after CEA for asymptomatic carotid stenosis. CASE DESCRIPTION: In this report we present an unusual case of RCVS associated with multifocal intraparenchymal hemorrhage, subarachnoid hemorrhage, subdural hematoma, and ischemic stroke after CEA for asymptomatic carotid stenosis. We review preexisting studies and draw correlations with implications for understanding the mechanisms of RCVS. CONCLUSIONS: A high index of suspicion should be maintained in post-CEA patients presenting with headaches or focal neurologic deficits, and vigilance with serial vascular imaging may help minimize long-term complications.
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare complication after carotid endarterectomy (CEA). Only a limited number of prior cases of RCVS have been reported after CEA for asymptomatic carotid stenosis. CASE DESCRIPTION: In this report we present an unusual case of RCVS associated with multifocal intraparenchymal hemorrhage, subarachnoid hemorrhage, subdural hematoma, and ischemic stroke after CEA for asymptomatic carotid stenosis. We review preexisting studies and draw correlations with implications for understanding the mechanisms of RCVS. CONCLUSIONS: A high index of suspicion should be maintained in post-CEA patients presenting with headaches or focal neurologic deficits, and vigilance with serial vascular imaging may help minimize long-term complications.
Authors: Masis Isikbay; Kazim H Narsinh; Sergio Arroyo; Wade S Smith; Daniel L Cooke; Randall T Higashida; Matthew R Amans Journal: J Vasc Surg Cases Innov Tech Date: 2020-10-27