Spontaneous intracerebral hemorrhage following carotid endarterectomy. Experience of 328 operations from 1983-1988.

In a consecutive series of 328 carotid endarterectomies there were two cases of postoperative intracerebral hemorrhage. The patients with transient ischemic attacks and subsequent major cerebral infarction had repair of their very tight carotid stenosis. Each developed intracerebral hemorrhage after a symptom free interval and hypertension was uncontrolled during the postoperative period. Hypertension is a significant complication of carotid endarterectomy and may be a prominent factor in the development of intracerebral hemorrhage after carotid endarterectomy. Also defective cerebrovascular autoregulation in chronic ischemic brain regions may predispose patients to intracerebral hemorrhage.