Cerebral hyperperfusion syndrome after stenting for revascularization of intracranial internal carotid artery dissection

Cerebral hyperperfusion syndrome (CHS) is one of the complications of cerebral revascularization. The main pathophysiology of CHS was considered to be cerebral autoregulation impairment due to long-standing cerebral hypoperfusion. Herein, we describe the case of a 40-year-old man with symptomatic intracranial arterial dissection (IAD) related to internal carotid artery stenosis. The patient underwent intracranial stenting 11 days after onset due to severe cerebral hypoperfusion presenting with neurological symptoms, and CHS presenting with intracerebral hemorrhage, post-operatively. The present case indicated not only the potential risk of CHS after intracranial stenting in IAD-related stenosis but also that cerebral hypoperfusion—even in a short period—might lead to CHS. •CHS after stenting for ICA dissection presenting with ischemia was described.•Even short term cerebral hypoperfusion may lead CHS after revascularization.•Poor collateral circulation was associated with CHS after revascularization.