{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:45:44Z","timestamp":1780616744256,"version":"3.54.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,12,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Carotid artery stent (CAS) placement and carotid endarterectomy can improve ocular ischemic syndrome (OIS). However, paradoxical visual deterioration due to neovascular glaucoma (NVG) may rarely occur after revascularization. The authors report a case of NVG developing after CAS placement, resulting in severe and irreversible vision loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 74-year-old man with severe right internal carotid artery stenosis and preoperative retinal ischemia underwent CAS placement. The stenosis was successfully resolved. On the day after the procedure, he developed a headache and was diagnosed with cerebral hyperperfusion syndrome, which stabilized with strict blood pressure control. Despite this, his headache persisted, accompanied by progressive visual deterioration. On postoperative day 10, ophthalmological evaluation confirmed NVG, and topical treatment was initiated. Nevertheless, the visual impairment remained irreversible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>NVG following carotid revascularization has no established preventive strategies and often leads to profound vision loss. Neurosurgeons and neurointerventionalists should recognize this potential complication. The authors recommend conducting preoperative and postoperative ophthalmological assessments for high-risk patients, including those with OIS or a history of cataract surgery.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25746\">https:\/\/thejns.org\/doi\/10.3171\/CASE25746<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25746","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:00Z","timestamp":1769083200000},"source":"Crossref","is-referenced-by-count":1,"title":["Neovascular glaucoma masked by cerebral hyperperfusion syndrome following carotid artery stent placement: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Ryosuke","family":"Dowaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7773-4661","authenticated-orcid":true,"given":"Yoshihiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Takeishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Takechi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"bib1","series-title":"Med Sci Monit","first-page":"RA138","article-title":"Ocular ischemic syndrome\u2014a systematic review","volume":"18","author":"Terelak-Borys","year":"2012","unstructured":"Terelak-Borys BSkonieczna KGrabska-Liberek I.Ocular ischemic syndrome\u2014a systematic review. Med Sci Monit. 2012;18(8):RA138-RA144."},{"issue":"5","key":"bib2","series-title":"Prog Retin Eye Res","first-page":"470","article-title":"Neovascular glaucoma","volume":"26","author":"Hayreh","year":"2007","unstructured":"Hayreh SS.Neovascular glaucoma. Prog Retin Eye Res. 2007;26(5):470-485."},{"key":"bib3","series-title":"J Ophthalmol","first-page":"350475","article-title":"Ocular circulation and chronic ocular ischemic syndrome before and after carotid artery revascularization surgery","volume":"2012","author":"Kawaguchi","year":"2012","unstructured":"Kawaguchi SIida JIUchiyama Y.Ocular circulation and chronic ocular ischemic syndrome before and after carotid artery revascularization surgery. J Ophthalmol. 2012;2012:350475."},{"issue":"3","key":"bib4","series-title":"Eur J Vasc Endovasc Surg","first-page":"322","article-title":"Editor\u2019s choice\u2014cerebral hyperperfusion syndrome after carotid artery stenting: a systematic review and meta-analysis","volume":"56","author":"Huibers","year":"2018","unstructured":"Huibers AEWesterink Jde Vries EE, et al. Editor\u2019s choice\u2014cerebral hyperperfusion syndrome after carotid artery stenting: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2018;56(3):322-333."},{"issue":"6","key":"bib5","series-title":"Int J Ophthalmol","first-page":"1005","article-title":"Etiology, pathogenesis, and diagnosis of neovascular glaucoma","volume":"15","author":"C\u0103lug\u0103ru","year":"2022","unstructured":"C\u0103lug\u0103ru DC\u0103lug\u0103ru M.Etiology, pathogenesis, and diagnosis of neovascular glaucoma. Int J Ophthalmol. 2022;15(6):1005-1010."},{"issue":"2","key":"bib6","series-title":"Ann Vasc Dis","first-page":"103","article-title":"Neovascular glaucoma post carotid endarterectomy: a case report and review of the literature","volume":"8","author":"Ng","year":"2015","unstructured":"Ng EChoong AMWalker PJ.Neovascular glaucoma post carotid endarterectomy: a case report and review of the literature. Ann Vasc Dis. 2015;8(2):103-105."},{"issue":"5","key":"bib7","series-title":"Am J Ophthalmol","first-page":"567","article-title":"Neovascular glaucoma and carotid artery obstructive disease","volume":"99","author":"Coppeto","year":"1985","unstructured":"Coppeto JRWand MBear LSciarra R.Neovascular glaucoma and carotid artery obstructive disease. Am J Ophthalmol. 1985;99(5):567-570."},{"issue":"8","key":"bib8","series-title":"Ann Ophthalmol","first-page":"304","article-title":"Increased intraocular pressure following endarterectomy","volume":"19","author":"Melamed","year":"1987","unstructured":"Melamed SIrvine JLee DA.Increased intraocular pressure following endarterectomy. Ann Ophthalmol. 1987;19(8):304-306."},{"issue":"5","key":"bib9","series-title":"J Vasc Surg","first-page":"551","article-title":"Chronic ocular ischemia and neovascular glaucoma: a result of extracranial carotid artery disease","volume":"8","author":"Wagner","year":"1988","unstructured":"Wagner WHWeaver FABrinkley JRBorchert MLindsay SF.Chronic ocular ischemia and neovascular glaucoma: a result of extracranial carotid artery disease. J Vasc Surg. 1988;8(5):551-557."},{"key":"bib10","series-title":"Bull Soc Belge Ophtalmol","first-page":"153","article-title":"A. carotis thrombosis with ocular ischemic syndrome: acute glaucoma postendarterectomy: a case report","volume":"243","author":"Daels","year":"1992","unstructured":"Daels HBostoen HCeuppens S.A. carotis thrombosis with ocular ischemic syndrome: acute glaucoma postendarterectomy: a case report. Bull Soc Belge Ophtalmol. 1992;243:153-158."},{"issue":"10","key":"bib11","series-title":"Ophthal Surg Lasers","first-page":"881","article-title":"Neovascular glaucoma after carotid endarterectomy","volume":"27","author":"Nguyen","year":"1996","unstructured":"Nguyen QHHamed LMSherwood MBRoseman RL.Neovascular glaucoma after carotid endarterectomy. Ophthal Surg Lasers. 1996;27(10):881-884."},{"issue":"4","key":"bib12","series-title":"Surg Neurol","first-page":"357","article-title":"Aggressive neovascular glaucoma following carotid endarterectomy: a case report","volume":"48","author":"Masuoka","year":"1997","unstructured":"Masuoka THirashima YEndo STakaku A.Aggressive neovascular glaucoma following carotid endarterectomy: a case report. Surg Neurol. 1997;48(4):357-359."},{"issue":"6","key":"bib13","series-title":"J Fr Ophtalmol","first-page":"599","article-title":"Glaucome n\u00e9ovasculaire diagnostiqu\u00e9 apr\u00e8s endart\u00e9riectomie carotidienne","volume":"23","author":"Cuevas-Lestienne","year":"2000","unstructured":"Cuevas-Lestienne CChiquet CZech JBurillon CTrepsat CDenis P.Glaucome n\u00e9ovasculaire diagnostiqu\u00e9 apr\u00e8s endart\u00e9riectomie carotidienne. Article in French. J Fr Ophtalmol. 2000;23(6):599-602."},{"issue":"3","key":"bib14","series-title":"Jpn J Clin Ophthalmol","first-page":"349","article-title":"Exacerbation of neovascular glaucoma in a case following carotid endarterectomy","volume":"59","author":"Takagi","year":"2005","unstructured":"Takagi MUeki MKawahara AExacerbation of neovascular glaucoma in a case following carotid endarterectomy. Jpn J Clin Ophthalmol. 2005;59(3):349-352."},{"issue":"6","key":"bib15","series-title":"Neurol Med Chir (Tokyo)","first-page":"418","article-title":"Deterioration of glaucoma after carotid endarterectomy","volume":"53","author":"Katsuta","year":"2013","unstructured":"Katsuta TFujimoto AOba K.Deterioration of glaucoma after carotid endarterectomy. Neurol Med Chir (Tokyo). 2013;53(6):418-421."},{"issue":"5","key":"bib16","series-title":"Interv Neuroradiol","first-page":"540","article-title":"Paradoxical development of neovascular glaucoma following carotid angioplasty and stenting","volume":"22","author":"Lee","year":"2016","unstructured":"Lee KMKim EJHeo SHJin KH.Paradoxical development of neovascular glaucoma following carotid angioplasty and stenting. Interv Neuroradiol. 2016;22(5):540-543."},{"issue":"2","key":"bib17","series-title":"J Vasc Surg Cases Innov Tech","first-page":"112","article-title":"Left acute neovascular glaucoma after right carotid endarterectomy","volume":"4","author":"Radojcic","year":"2018","unstructured":"Radojcic MAbell RChuen J.Left acute neovascular glaucoma after right carotid endarterectomy. J Vasc Surg Cases Innov Tech. 2018;4(2):112-114."},{"issue":"11","key":"bib18","series-title":"J Neuroendovascular Ther","first-page":"553","article-title":"Two patients with a rapid increase in the ocular pressure after carotid artery stenting for cervical internal carotid artery stenosis with ocular ischemic syndrome","volume":"12","author":"Kawano","year":"2018","unstructured":"Kawano TSaito KHidaka TTwo patients with a rapid increase in the ocular pressure after carotid artery stenting for cervical internal carotid artery stenosis with ocular ischemic syndrome. J Neuroendovascular Ther. 2018;12(11):553-559."},{"key":"bib19","first-page":"100012Z17BL2019","article-title":"Hyperperfusion syndrome: aggravation of neovascular glaucoma after stenting for internal carotid artery stenosis. J Case Rep Images Ophthalmol.","volume":"2","author":"Loving","year":"2019","unstructured":"Loving BSQiu HWalker JAnderson ML.Hyperperfusion syndrome: aggravation of neovascular glaucoma after stenting for internal carotid artery stenosis. J Case Rep Images Ophthalmol. 2019;2:100012Z17BL2019."},{"issue":"4","key":"bib20","series-title":"Neurohospitalist","first-page":"301","article-title":"Severe neovascular glaucoma exacerbation as a complication of carotid artery stenting: a case report","volume":"10","author":"Mannava","year":"2020","unstructured":"Mannava STorres LFDeSousa KGSevere neovascular glaucoma exacerbation as a complication of carotid artery stenting: a case report. Neurohospitalist. 2020;10(4):301-304."},{"issue":"2","key":"bib21","series-title":"Neurol India","first-page":"408","article-title":"Acute glaucoma following internal carotid artery stenting: a rare but serious complication of ocular ischemic syndrome","volume":"72","author":"Witton-Davies","year":"2024","unstructured":"Witton-Davies TLGerdsmeier-Petz WMeier OSchulte-Altedorneburg G.Acute glaucoma following internal carotid artery stenting: a rare but serious complication of ocular ischemic syndrome. Neurol India. 2024;72(2):408-410."},{"issue":"8","key":"bib1","series-title":"Med Sci Monit","first-page":"RA138","article-title":"Ocular ischemic syndrome\u2014a systematic review","volume":"18","author":"Terelak-Borys","year":"2012","unstructured":"Terelak-Borys BSkonieczna KGrabska-Liberek I.Ocular ischemic syndrome\u2014a systematic review. Med Sci Monit. 2012;18(8):RA138-RA144."},{"issue":"5","key":"bib2","series-title":"Prog Retin Eye Res","first-page":"470","article-title":"Neovascular glaucoma","volume":"26","author":"Hayreh","year":"2007","unstructured":"Hayreh SS.Neovascular glaucoma. Prog Retin Eye Res. 2007;26(5):470-485."},{"key":"bib3","series-title":"J Ophthalmol","first-page":"350475","article-title":"Ocular circulation and chronic ocular ischemic syndrome before and after carotid artery revascularization surgery","volume":"2012","author":"Kawaguchi","year":"2012","unstructured":"Kawaguchi SIida JIUchiyama Y.Ocular circulation and chronic ocular ischemic syndrome before and after carotid artery revascularization surgery. J Ophthalmol. 2012;2012:350475."},{"issue":"3","key":"bib4","series-title":"Eur J Vasc Endovasc Surg","first-page":"322","article-title":"Editor\u2019s choice\u2014cerebral hyperperfusion syndrome after carotid artery stenting: a systematic review and meta-analysis","volume":"56","author":"Huibers","year":"2018","unstructured":"Huibers AEWesterink Jde Vries EE, et al. Editor\u2019s choice\u2014cerebral hyperperfusion syndrome after carotid artery stenting: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2018;56(3):322-333."},{"issue":"6","key":"bib5","series-title":"Int J Ophthalmol","first-page":"1005","article-title":"Etiology, pathogenesis, and diagnosis of neovascular glaucoma","volume":"15","author":"C\u0103lug\u0103ru","year":"2022","unstructured":"C\u0103lug\u0103ru DC\u0103lug\u0103ru M.Etiology, pathogenesis, and diagnosis of neovascular glaucoma. Int J Ophthalmol. 2022;15(6):1005-1010."},{"issue":"2","key":"bib6","series-title":"Ann Vasc Dis","first-page":"103","article-title":"Neovascular glaucoma post carotid endarterectomy: a case report and review of the literature","volume":"8","author":"Ng","year":"2015","unstructured":"Ng EChoong AMWalker PJ.Neovascular glaucoma post carotid endarterectomy: a case report and review of the literature. Ann Vasc Dis. 2015;8(2):103-105."},{"issue":"5","key":"bib7","series-title":"Am J Ophthalmol","first-page":"567","article-title":"Neovascular glaucoma and carotid artery obstructive disease","volume":"99","author":"Coppeto","year":"1985","unstructured":"Coppeto JRWand MBear LSciarra R.Neovascular glaucoma and carotid artery obstructive disease. Am J Ophthalmol. 1985;99(5):567-570."},{"issue":"8","key":"bib8","series-title":"Ann Ophthalmol","first-page":"304","article-title":"Increased intraocular pressure following endarterectomy","volume":"19","author":"Melamed","year":"1987","unstructured":"Melamed SIrvine JLee DA.Increased intraocular pressure following endarterectomy. Ann Ophthalmol. 1987;19(8):304-306."},{"issue":"5","key":"bib9","series-title":"J Vasc Surg","first-page":"551","article-title":"Chronic ocular ischemia and neovascular glaucoma: a result of extracranial carotid artery disease","volume":"8","author":"Wagner","year":"1988","unstructured":"Wagner WHWeaver FABrinkley JRBorchert MLindsay SF.Chronic ocular ischemia and neovascular glaucoma: a result of extracranial carotid artery disease. J Vasc Surg. 1988;8(5):551-557."},{"key":"bib10","series-title":"Bull Soc Belge Ophtalmol","first-page":"153","article-title":"A. carotis thrombosis with ocular ischemic syndrome: acute glaucoma postendarterectomy: a case report","volume":"243","author":"Daels","year":"1992","unstructured":"Daels HBostoen HCeuppens S.A. carotis thrombosis with ocular ischemic syndrome: acute glaucoma postendarterectomy: a case report. Bull Soc Belge Ophtalmol. 1992;243:153-158."},{"issue":"10","key":"bib11","series-title":"Ophthal Surg Lasers","first-page":"881","article-title":"Neovascular glaucoma after carotid endarterectomy","volume":"27","author":"Nguyen","year":"1996","unstructured":"Nguyen QHHamed LMSherwood MBRoseman RL.Neovascular glaucoma after carotid endarterectomy. Ophthal Surg Lasers. 1996;27(10):881-884."},{"issue":"4","key":"bib12","series-title":"Surg Neurol","first-page":"357","article-title":"Aggressive neovascular glaucoma following carotid endarterectomy: a case report","volume":"48","author":"Masuoka","year":"1997","unstructured":"Masuoka THirashima YEndo STakaku A.Aggressive neovascular glaucoma following carotid endarterectomy: a case report. Surg Neurol. 1997;48(4):357-359."},{"issue":"6","key":"bib13","series-title":"J Fr Ophtalmol","first-page":"599","article-title":"Glaucome n\u00e9ovasculaire diagnostiqu\u00e9 apr\u00e8s endart\u00e9riectomie carotidienne","volume":"23","author":"Cuevas-Lestienne","year":"2000","unstructured":"Cuevas-Lestienne CChiquet CZech JBurillon CTrepsat CDenis P.Glaucome n\u00e9ovasculaire diagnostiqu\u00e9 apr\u00e8s endart\u00e9riectomie carotidienne. Article in French. J Fr Ophtalmol. 2000;23(6):599-602."},{"issue":"3","key":"bib14","series-title":"Jpn J Clin Ophthalmol","first-page":"349","article-title":"Exacerbation of neovascular glaucoma in a case following carotid endarterectomy","volume":"59","author":"Takagi","year":"2005","unstructured":"Takagi MUeki MKawahara AExacerbation of neovascular glaucoma in a case following carotid endarterectomy. Jpn J Clin Ophthalmol. 2005;59(3):349-352."},{"issue":"6","key":"bib15","series-title":"Neurol Med Chir (Tokyo)","first-page":"418","article-title":"Deterioration of glaucoma after carotid endarterectomy","volume":"53","author":"Katsuta","year":"2013","unstructured":"Katsuta TFujimoto AOba K.Deterioration of glaucoma after carotid endarterectomy. Neurol Med Chir (Tokyo). 2013;53(6):418-421."},{"issue":"5","key":"bib16","series-title":"Interv Neuroradiol","first-page":"540","article-title":"Paradoxical development of neovascular glaucoma following carotid angioplasty and stenting","volume":"22","author":"Lee","year":"2016","unstructured":"Lee KMKim EJHeo SHJin KH.Paradoxical development of neovascular glaucoma following carotid angioplasty and stenting. Interv Neuroradiol. 2016;22(5):540-543."},{"issue":"2","key":"bib17","series-title":"J Vasc Surg Cases Innov Tech","first-page":"112","article-title":"Left acute neovascular glaucoma after right carotid endarterectomy","volume":"4","author":"Radojcic","year":"2018","unstructured":"Radojcic MAbell RChuen J.Left acute neovascular glaucoma after right carotid endarterectomy. J Vasc Surg Cases Innov Tech. 2018;4(2):112-114."},{"issue":"11","key":"bib18","series-title":"J Neuroendovascular Ther","first-page":"553","article-title":"Two patients with a rapid increase in the ocular pressure after carotid artery stenting for cervical internal carotid artery stenosis with ocular ischemic syndrome","volume":"12","author":"Kawano","year":"2018","unstructured":"Kawano TSaito KHidaka TTwo patients with a rapid increase in the ocular pressure after carotid artery stenting for cervical internal carotid artery stenosis with ocular ischemic syndrome. J Neuroendovascular Ther. 2018;12(11):553-559."},{"key":"bib19","first-page":"100012Z17BL2019","article-title":"Hyperperfusion syndrome: aggravation of neovascular glaucoma after stenting for internal carotid artery stenosis. J Case Rep Images Ophthalmol.","volume":"2","author":"Loving","year":"2019","unstructured":"Loving BSQiu HWalker JAnderson ML.Hyperperfusion syndrome: aggravation of neovascular glaucoma after stenting for internal carotid artery stenosis. J Case Rep Images Ophthalmol. 2019;2:100012Z17BL2019."},{"issue":"4","key":"bib20","series-title":"Neurohospitalist","first-page":"301","article-title":"Severe neovascular glaucoma exacerbation as a complication of carotid artery stenting: a case report","volume":"10","author":"Mannava","year":"2020","unstructured":"Mannava STorres LFDeSousa KGSevere neovascular glaucoma exacerbation as a complication of carotid artery stenting: a case report. Neurohospitalist. 2020;10(4):301-304."},{"issue":"2","key":"bib21","series-title":"Neurol India","first-page":"408","article-title":"Acute glaucoma following internal carotid artery stenting: a rare but serious complication of ocular ischemic syndrome","volume":"72","author":"Witton-Davies","year":"2024","unstructured":"Witton-Davies TLGerdsmeier-Petz WMeier OSchulte-Altedorneburg G.Acute glaucoma following internal carotid artery stenting: a rare but serious complication of ocular ischemic syndrome. 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