Abstract
Cerebral hemorrhage, an unusual complication of endarterectomy, is often attributed to postoperative hypertension. A patient with a middle cerebral artery stroke had a hemorrhage without hypertension, 2 days postoperatively. Pronounced contrast enhancement of the infarction during the 7 weeks prior to surgery reflected severe disruption of the blood-brain barrier. Contrast CT scans may detect patients at risk for post-endarterectomy hemorrhage even 2 months after a stroke or TIA.