Abstract
To predict postoperative ischemic brain complications due to temporary or permanent carotid occlusion is very important for surgical treatment of occlusive cerebrovascular disease. We studied CBF changes by SPECT and EEG changes by computed mapping of EEG (CME) preoperatively and ICA stump pressure and somatosensory evoked potential (SEP) were measured intraoperatively. Mean CBF in the affected MCA territory was 47 ml and 37 ml on the average before and after CCA compression. There was a significant difference between them. CME showed an appearance or increase in delta-activity by compression of CCA in six cases and no evident change was observed in other 15 cases. Mean CBF was 33 ml in six cases in whom appearance or increase in delta-activity was observed by the compression. On the other hand, mean CBF was 42 ml in other cases with no change in deltaactivity. With respect to the relation-ship between ICA stump pressure and changes in delta activity of EEG in the affected hemisphere, mean stump pressure was 40 mmHg in cases with changes of EEG and 63 mmHg in cases without changes. These values are significantly different. In relation to SEP measured in surgery and stump pressure, in cases with the amplitude of the early component of SEP was reduced by 50% or more were found to have a stump pressure of <40 mmHg.
In addition to preoperative compression (Matas) CBF measurement and CME, intraoperative monitorings are considered necessary to minimize postoperative complications.
