During carotid endarterectomy (CEA), we monitored somatosensory evoked responses (SERs) ipsilaterally over the scalp following stimulation of the contralateral median nerve at the wrist. Thirty-eight CEAs in 36 patients were studied. Of the 10 CEAs performed with patients under general anesthesia, three involved marked changes in SERs, reversed by shunt insertion. The remaining 28 CEAs were done with patients under local anesthesia. The SERs remained stable during an average clamp time of 30 minutes in all except one patient, in whom SER changes developed within a minute of clamping; the changes were reversed by shunt replacement. Four of the 38 CEAs required a shunt based on SER changes, although measurement of stump pressure (<50 mm Hg) would have indicated the necessity of a shunt in eight additional operations. We concluded that SERs are useful in signaling cerebral ischemia and the need for a shunt during CEA.
|Original language||English (US)|
|Number of pages||4|
|Journal||Archives of Neurology|
|State||Published - Apr 1984|
ASJC Scopus subject areas
- Arts and Humanities (miscellaneous)
- Clinical Neurology