Fatal Subarachnoid Hemorrhage From Ruptured Intracerebral Aneurysm After Carotid Endarterectomy.

Concomitant carotid stenosis with cerebral aneurysm is a rare entity with an incidence reported to be about 1.9-3.2%. The effect of carotid revascularization on pre-existing cerebral aneurysm, along with risk factors for aneurysmal rupture, is not fully understood. We report a 61-year-old man who underwent carotid endarterectomy (CEA) for symptomatic carotid stenosis, and 6 days post-operatively the patient suffered a fatal subarachnoid hemorrhage from the rupture of a known basilar artery aneurysm. This rare but potentially fatal complication of a ruptured cerebral aneurysm after CEA warrants a discussion on the management of concomitant pathology.