Intracranial hemorrhage after carotid artery stenting in both anterior and posterior circulation: A case report

RATIONAL: Intracranial hemorrhage (ICH) after carotid artery stenting (CAS) is a rare but fatal complication, and it primarily occurs in the corresponding vascular distribution area. Herein, a case of ICH after CAS in both anterior and posterior circulation has been described. PATIENT CONCERNS: A 62-year-old female was referred to the hospital for left-side limb weakness and right nasal hemianopia for 1 month. DIAGNOSIS: Cerebral MRI following hospitalization revealed cerebral infarction in the right posterior cortical watershed area. Computed tomography angiography (CTA) showed severe stenosis in the right internal carotid artery. INTERVENTIONS: We performed CAS to treat the right internal carotid artery stenosis without any complications. OUTCOMES: After CAS, cerebral hemorrhage occurred under strict control of blood pressure in both anterior and posterior circulation. After 69 days of treatment, the patient was discharged from the hospital. LESSONS: Hypertension is still one of the causes of ICH after CAS. The control of perioperative BP in patients with severe carotid stenosis is yet a major concern.