Hyperperfusion syndrome is a well-documented complication of carotid endart
erectomy, as well as internal carotid artery angioplasty and stent placemen
t. We report a similar complication after distal intracranial (middle cereb
ral artery [MCA] M2 segment) angioplasty. To our knowledge, this is the fir
st report of hyperperfusion syndrome after intracranial angioplasty of a di
stal MCA branch.