A 49-year-old Woman of a Massive Cerebral Hemorrhage After Carotid Artery Stenting for Traumatic Internal Carotid Artery Stenosis due to an Elongated Styloid Process

Abstract

Objective: To present a case of traumatic dissecting internal carotid artery stenosis due to an elongated styloid process.

Case Presentation: A 49-year-old woman felt neck pain after neck movement during fishing, and then she developed right hemiparesis and aphasia. Head MRI showed no cerebral infarcts, and neck MRA showed left internal carotid artery stenosis with a dissecting aneurysm near her left elongated styloid process. Her symptoms gradually improved, and she was treated conservatively. However, on the 6th disease day, right hemiparesis and aphasia re-appeared. Since head MRI and neck MRA showed cerebral infarcts and progression of left internal carotid artery stenosis, carotid artery stenting was performed. A massive cerebral hemorrhage due to postoperative hyperperfusion was observed 2 hours after stenting.

Conclusion: Following percutaneous transluminal angioplasty or stenting for dissecting internal carotid artery stenosis that evolved over a short period, attention must be paid to intracranial bleeding due to postoperative hyperperfusion.