Idit Melnik, Yafm Harach, Boris Yoffe, Department of General and Vascular Surgery, Barzilai Medical Center, Ashkelon, Israel; Af- fliated with the Faculty of Health Sciences, Ben-Gurion University of the Negev. Ehud Atoun, Ronen Debi, Ornit Cohen, Department of Orthope- dics, Barzilai Medical Center, Ashkelon, Israel; Affliated with the Faculty of Health Sciences, Ben-Gurion University of the Negev. Ofer Levy, Reading Shoulder Unit, Royal Berkshire Hospital, Read- ing, the United Kingdom Confict-of-interest statement: The author(s) declare(s) that there is no confict of interest regarding the publication of this paper. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Com- mons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non- commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Correspondence to: Ehud Atoun MD, Department of Orthope- dics, Barzilai Medical Center, Ashkelon, Israel. Email: dratoun@gmail.com Telephone: +972577678722 Fax: +97246380044 Received: June 14, 2016 Revised: January 18, 2017 Accepted: January 22 2017 Published online: April 28, 2017 ABSTRACT Changes in blood pressure after carotid endarterectomy (CEA) may lead to the cerebral hyperperfusion syndrome (CHS), which might be accompanied by postoperative seizures. We report a case of a 71- year old man that underwent left CEA and developed a tonic-clonic seizure in the recovery room after hearing a familiar voice. Physical and radiological imaging revealed a massive rotator cuff tear and locked posterior shoulder dislocation of the right humerus with a large impaction fracture. He was successfully treated with a reverse shoulder arthroplasty and gained good functional results. Key words: Shoulder, Dislocation, Carotid enartherectomy, Seizure © 2017 The Author(s). Published by ACT Publishing Group Ltd. All rights reserved. Melnik I, Atoun E, Debi R, Harach Y, Levy O, Cohen O, Yoffe B. Posterior Shoulder Dislocation As a Post-Operative Complication of Carotid Endarterectomy: Case Report and Review of Literature. International Journal of Orthopaedics 2017; 4(1): 730-732 Available from: URL: http: //www.ghrnet.org/index.php/ijo/article/view/1756 INTRODUCTION Carotid endarterectomy (CEA) is most commonly performed for a high-grade internal carotid artery stenosis. Manipulation of the carotid bulb during carotid endarterectomy may results in hemodynamic instability intraoperatively and in the early postoperative period. Thus, it is standard care for CEA patients to be placed in a monitored setting of blood pressure. Those changes in blood pressure may lead to the cerebral hyperperfusion syndrome (CHS), a rear syndrome which causes most of postoperative intracerebral hemorrhages and seizures in the frst two weeks after surgery. Posterior shoulder dislocation has repeatedly been reported as a complication of convulsive disorders. The dislocation is frequently accompanied by a massive rotator cuff tear and an aterior humeral head impaction fracture (reverse hill sachs lesion). We report a case of a posterior fracture dislocation of the shoulder with a massive rotator cuff tear following CEA. This is a complication that has not been previously reported in the literature. CASE REPORT A 71-year-old man with a history of diabetes mellitus, coronary artery disease, and peripheral arterial disease underwent a left CEA with Dacron patch angioplasty for asymptomatic high-grade stenosis under CASE REPORT Posterior Shoulder Dislocation As a Post-Operative Complication of Carotid Endarterectomy: Case Report and Review of Literature Idit Melnik, Ehud Atoun, Ronen Debi, Yafm Harach, Ofer Levy, Ornit Cohen, Boris Yoffe 730 Int. J. of Orth. 2017 April 28; 4(2): 730-732 ISSN 2311-5106 (Print), ISSN 2313-1462 (Online) Online Submissions: http://www.ghrnet.org/index.php/ijo doi:10.17554/j.issn.2311-5106.2017.04.181 International Journal of Orthopaedics