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Ann Saudi Med 31(4) July-August 2011 www.saudiannals.net 433 The patient was treated conservatively and recovered partially, and at the 2-month follow-up there was mild right limb paresis. If we consider this case HPS, there is an unusual late presentation, six days after carotid artery stenting in a normotensive patient. Although there are claims that severe ipsilateral stenosis, impaired collateral blood flow secondary to an advanced occlusive disease in other extracranial cerebral vessels or an incomplete circle of Willis, periand postoperative hypertension are main risk factors for developing HPS and intracerebral hemorrhage after CAS, our case showed that this complication may happen even in a patient without these risk factors and also as a late presentation, six days after intervention.

Re: Prevalence of chronic obstructive pulmonary disease among smokers attending primary health-care clinics in Saudi Arabia