Intraoperative Electroencephalographic Changes During Carotid Endarterectomy

J Korean Neurol Assoc > Volume 14(3); 1996 > Article

Journal of the Korean Neurological Association 1996;14(3): 679-687.

경동맥내막절제술동안 관찰된 뇌파 변화

서대원, 노숙영* 이일근** 홍승봉 정진상 이광호 김동익*** 이병붕*** 최낙천

삼성의료원 신경과, 이화여자대학교* 인하대학교**, 신경과 일반외과

Intraoperative Electroencephalographic Changes During Carotid Endarterectomy

Dae Won Seo, M.D. , Sook Young Roh, M.D. *, Il Keun Lee, M.D. **, Seung Bong Hong, M.D. , Chin Sang Jung, M.D. , Kwang Ho Lee, M.D., Dong Ik Kim, M.D. ***, Byung Boong Lee, M.D. ***, Nack Cheon Choi, M.D.

Departments of Neurology and General Surgery *** Samsung Medical Center Ewha Womans University **

Abstract

Continuous electroencephalographic (EEG) monitoring is the widely used method of operative surveillance during carotid endarterectomy. EEG changes have been well known when cerebral ischemic event occurs during the carotid endarterectomy. But in our country intraoperative EEG monitoring during the operation was not popular and was not reported yet. We have experienced four patients showing EEG changes during the operation. EEG monitoring was performed using four channel differential montages in four patients with carotid artery disease. We evaluated the changes of EEG monitoring during the carotid endarterectomy. We also performed somatosensory evoked potentials (SEP) monitoring to backup the EEG monitoring which could miss the small embolic subcortical infarction. They revealed significant EEG changes which were the decreased fast activities and increased slowing during the carotid cross clamping. They were normalized after insertion of shunt. In one subject EEG change reappeared while the shunt was inserted, because the shunt was kinked, In all subjects, the significant changes of SEP were not observed after declamping of ICA or reposition of kinked shunt. There were not any immediate postoperative neurologic deficits in all patients. EEG monitoring might be considered as an useful method to detect ischemic changes during carotid endarterectomy and to know whether the inserted shunt is working well, Key Words : Intraoperative neuromonitoring, Carotid endarterectomy