Severe Headache After Carotid Endarterectomy

SYNOPSIS A woman developed severe recurrent headache associated with transient neurologic dysfunction while recuperating from carotid endarterectomy performed for transient ischemic attacks. She had severe carotidstenosis preoperatively, but when studied during the period of severe headache had an angiographically normal carotid artery territory. The headaches and neurologic dysfunction appeared after a postoperative headache free period of 72 hours, were self limited, and had characteristics of migraine. Migrainous post‐endarterectomy headache may be a manifestation of disordered autoregulation of cerebral blood flow.