A 62-year-old man presented with mild left hemiparesis, headache and blurred

vision of his right eye

Teaching NeuroImagesNeurology

Resident and Fellow Section

© 2013 American Academy of Neurology

• 62 year-old man• Presented with mild left hemiparesis,

headache, blurred vision in the right eye• The patient had undergone

thromboendarterectomy 10 days prior due to symptomatic subtotal stenosis of his right internal carotid artery.

Ketteler, et al.

Vignette

Ketteler, et al.

MRI Brain

Ketteler, et al.

Fundoscopic Evaluation

Combined retinal and cerebral hyperperfusion syndrome after

carotid thromboendarterectomy

Ketteler, et al.

• Cerebral hyperperfusion syndrome (CHS) occurs in around 3% of patients undergoing carotid thromboendarterectomy and can induce severe neurological deficits.1 Rarely, hyperperfusion also involves the ipsilateral eye.2

• Under careful blood pressure control, this patient’s symptoms and brain edema fully resolved within weeks.