Intracerebral Hemorrhage After Carotid Endarterectomy

Intracerebral hemorrhage (ICH) is a rare complication of carotid endarterectomy (CE). In our multicenter series of 1,180 CE (Baker-Littooy), three ICH occurred, of which two were fatal. One patient was receiving anticoagulants because ofa prosthetic aortic valve; another had rupture of a known ipsilateral intracranial aneurysm. Both occurred more than six weeks postoperatively. The third patient, who was hypertensive, had a nonfatal ipsilateral thalamic hemorrhage on the third postoperative day. Though these three patients represent only 0.25% of our series, they constitute 12% of our total strokes. ICH constitutes the largest percentage of nontechnically-related strokes and noncardiac deaths after CE