Hemiparesis following carotid endarterectomy: comparison of monitoring methods
Grundy, B.L.; Sanderson, A.C.; Webster, W.W.; Richey, E.T.; Procopio, P.; Karanjia, P.N.
Anesthesiology 55(4): 462-466
1981
ISSN/ISBN: 0003-3022 PMID: 7294385 Document Number: 176920
Intraoperative monitoring of brain function may reduce the incidence of neurologic morbidity associated with carotid endarterectomy. Some surgeons measure carotid artery stump pressure or regional cerebral blood flow to assess cerebral circulation during carotid occlusion. Others routinely employ carotid artery shunts. Brain function can be monitored using clinical neurologic assessment in patients operated upon under regional anesthesia or electroencephalography (EEG) during general anesthesia. With either of these monitoring methods, routine insertion of a carotid artery shunt and its complications can be avoided in those patients with collateral circulation adequate to maintain cerebral function during carotid artery occlusion. Intraoperative neurologic assessment, on-line EEG monitoring and off-line EEG signal analysis were compared in a patient who developed mild hemiparesis after carotid endarterectomy.