We describe a newborn who underwent balloon dilatation of critical aortic stenosis and surgical correction of coarctation of the aorta. Postoperative Doppler echocardiogram revealed diastolic retrograde flow in the distal aortic arch and increased systolic flow as well as diastolic forward flow in the left common carotid artery. Cranial computed tomography suggested increased left middle cerebral artery flow and a subacute infarction with luxury perfusion and damage to the blood brain barrier. Therefore, in the absence of another reason for diastolic "run-off" in the distal aortic arch, this flow pattern may represent the echocardiographic sign for cerebral hyperemia associated with subacute ischemia.