Cerebral vasoconstriction as a complication of carotid endarterectomy. Case report.

The case is presented of an elderly man with an acute confusional state occurring soon after he had undergone a right carotid endarterectomy. Angiography demonstrated segmental areas of cerebral vasoconstriction and an electroencephalogram revealed periodic lateralized epileptiform discharges, both involving the right hemisphere. Cerebral hyperperfusion has been implicated in the genesis of several transient neurological syndromes following carotid endarterectomy. This case suggests that cerebral vasoconstriction may also be associated with impairment of cerebrovascular autoregulation observed after this procedure.