Hyperperfusion syndrome is a complication with frequency about 3 per cent and unclear etiological factors who mostly lead to hard neurological deficit and/or death for the patient. Symptoms are headaches, fits, confusion, focal neurological sings to intracerebral hemorrhage. The prevention and control are accomplished by active monitoring of intracranial blood flow and systolic blood pressure. Hyperperfusion syndrome can be clinicaly performed with or without hemorrhage. We present a case of hyperperfusion syndrome after carotid endarterectomy of 59-years-old man operated at the Department of Vascular surgery and Angiology of "St. Ekaterina" hospital. The patient had thrombosis of one carotid artery and stenosis of the other and two old cerebral infarctions. In the early postoperative period the patient developed a clinical picture of awake coma with quadriparesis and right plegia. On the 14-th day after the surgical intervention the patient left the clinic in better condition and was directed to his neurologist for observation.
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