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Case Reports in Neurological Medicine
Volume 2017 (2017), Article ID 7965758, 3 pages
https://doi.org/10.1155/2017/7965758
Case Report

Uncommon Etiology for Seizure: Cerebral Hyperperfusion Syndrome

1Department of Neurology, Inova Fairfax Hospital, Falls Church, VA, USA
2VCU School of Medicine, Inova Campus, Falls Church, VA, USA
3Department of Neurology, VCU School of Medicine, Inova Campus, Falls Church, VA, USA

Correspondence should be addressed to Mohankumar Kurukumbi

Received 1 January 2017; Revised 23 March 2017; Accepted 19 April 2017; Published 10 May 2017

Academic Editor: Isabella Laura Simone

Copyright © 2017 Mohankumar Kurukumbi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cerebral hyperperfusion syndrome (CHS) is a rare life-threatening complication of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis. The incidence varies between 0 and 3%, depending on the severity of the stenosis, perioperative hypertension, and contralateral carotid stenosis. This case report reports a 53-year-old female patient presenting with decreased alertness and multiple tonic-clonic seizures, in the background of bilateral CEA. She was found to have bilateral carotid stenosis. Her left CEA was performed three months prior and right CEA was four days prior to her current presentation with seizures. After bilateral CEA, the imaging showed extensive pathologic process involving primarily the subcortical white matter and overlying cortex, more on the right cerebral hemisphere. On follow-up six weeks later, she reported no recurrent seizures and imaging showed decrease in abnormal signal intensity of the grey and white matter. This was indicative of near complete resolution of hyperperfusion damage. CHS is a rare complication due to the loss of autoregulation of the cerebrovascular system and increased blood flow status after bilateral CEA. This case is reported because of a rare and unique presentation of seizures in the background of bilateral CEA.