Abstract
We report a case of delayed intracerebral hemorrhage caused by cerebral hyperperfusion after carotid endarterectomy (CEA). The patient was a 70-year-old hypertensive man who presented with aphasia. CEA was performed to relieve severe stenosis of the left internal carotid artery. Magnetic resonance (MR) imaging and single-photon emission computed tomography (SPECT) performed 10 days and 18 clays after surgery, respectively, showed a hyperperfused area in the subcortical region of the left cerebral hemisphere. Although the patient was discharged without neurological deficits, he developed a subcortical hemorrhage on the 24th postoperative day in the region shown to be hyperperfused on MR imaging and SPECT. Longer follow-up and vigorous control of blood pressure are necessary to prevent the occurrence of intracerebral hemorrhage in patients with cerebral hyperperfusion following CEA.
