A 65-year-old woman experienced an acute onset of expressive dysphasia 48 hours after a left carotid endarterectomy. A computed tomographic (CT) head scan revealed a 35-cm3left frontal hematoma (Figure, A). The patient improved with conservative management. A CT scan performed 9 weeks later demonstrated hypodensity with ring enhancement postcontrast (Figure, B and C). Subsequent magnetic resonance imaging findings of negative mass effect and uniform hemosiderin staining weighed against an associated tumor or abscess1 (Figure, D).