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J Neuroimaging. 2008 Jan;18(1):96-100. doi: 10.1111/j.1552-6569.2007.00172.x.

Are limb-shaking transient ischemic attacks a risk factor for postendarterectomy hemorrhage? Case report and literature review.

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Medical College of Georgia - Neurology, Augusta, GA 30909, USA.


Postoperative intracerebral hemorrhage occurs in about 0.5% of all carotid endarterectomies. There are no recognized risk factors for this complication. We report on a 74-year-old woman with right sided limb-shaking transient ischemic attacks and severe stenosis of the left internal carotid artery. She suffered a fatal intracerebral hemorrhage 11 days after endarterectomy. This case prompted a review of the literature to determine if limb-shaking transient ischemic attacks might be a risk factor for postoperative intracerebral hemorrhage. We propose that patients with limb-shaking transient ischemic attacks have loss of vasomotor reactivity placing them at high risk for carotid reperfusion syndrome and hemorrhage into the revascularized territory.

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