Fatal intracerebral haemorrhage following carotid endarterectomy in a patient with cerebral amyloid angiopathy.
A 68-year-old man underwent carotid endarterectomy for symptomatic carotid artery stenosis. Immediately after surgery the patient suffered dramatic neurological deterioration, due to massive cerebral bleeding. Pathological examination revealed cerebral amyloid angiopathy. This condition is known to predispose to spontaneous, as well as anticoagulation induced, cerebral haemorrhage. Surgical intervention needing anticoagulation in elderly patients at risk for congophilic angiopathy should be performed with extreme caution.
Willems
S
S
Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Debing
E
E
Michotte
A
A
Chaskis
C
C
Van den Brande
P
P
D000368:Aged; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000209:etiology*; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008297:Male