We tried to determine whether postoperative CNS complications after off-pump coronary artery bypass grafting (OPCABG) are related to prior cerebral infarction or intracranial artery disease. Fiftyfive patients (among them, 40 men; mean age 64.6 +/- 8.9 years) subjected to OPCABG underwent neurological and neuropsychological examinations 24 h before surgery. MRI was used to identify old and/or new ischemic lesions before surgery, and MRA was used to determine the presence and severity of intracranial artery disease. The patients were examined eight days after surgery; possible development of stroke or cognitive dysfunction was evaluated. Associations between postoperative stroke and potential predictors, including prior cerebral infarction and intracranial artery disease, were analyzed using univariate methods. Two of 55 (3.64%) patients had postoperative stroke, and no patient showed cognitive decline. Univariate analysis found no significant association between postoperative stroke and prior cerebral infarction detected by MRI (P = 0.378) or intracranial artery disease detected by MRA (P = 0.103). Our results suggest that intracranial artery disease and prior cerebral infarction are not independent risk factors for stroke after OPCABG. Nonetheless, further investigation of these associations is necessary.