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Fulminant reversible cerebral vasoconstriction syndrome after carotid endarterectomy for asymptomatic stenosis.

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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… Click to show full 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.

Keywords: cerebral vasoconstriction; vasoconstriction syndrome; carotid; carotid endarterectomy; stenosis; reversible cerebral

Journal Title: World neurosurgery
Year Published: 2019

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