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Article
January 1991

EEG Monitoring in Carotid Endarterectomy

Author Affiliations

Los Angeles, Calif

Arch Surg. 1991;126(1):115. doi:10.1001/archsurg.1991.01410250123024

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Abstract

To the Editor.—We agree with many of the conclusions and observations made by Elmore and colleagues1 in the June 1990 issue of the Archives regarding monitoring for carotid endarterectomy with computerized electroencephalographic (EEG) brain mapping. However, in their discussion of our previous reports on this topic, they incorrectly cited the criteria we used. They said we used only new asymmetry as a criterion for EEG "change." However, we actually reported2,3 on any significant EEG "change" on carotid cross-clamping, whether it was a new asymmetry or a generalized change from intraoperative preclamp baseline EEG. We only required that the change be substantially greater than the ordinary fluctuations seen during the routine baseline portion of the operation, prior to clamping. Many of the changes reported in our study were indeed generalized changes of the EEG background, including generalized loss of fast activity, increase in slow activity, or, occasionally, a

References
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Elmore JR, Eldrup-Jorgensen J, Leschey WH, Herbert WE, Dillihunt RC, Ray FS.  Computerized topographic brain mapping during carotid endarterectomy . Arch Surg . 1990;125:734-738.Article
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Ahn SS, Jordan SE, Nuwer MR.  Computed electroencephalographic topographic brain mapping . In: Moore WS, ed. Surgery for Cerebrovascular Disease . New York, NY: Churchill Livingstone Inc; 1987:275-280.
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Brinkman SD, Braun P, Ganji S, Morrell RM, Jacobs LA.  Neuropsychological performance one week after carotid endarterectomy reflects intra-operative ischemia . Stroke . 1984;15:497-503.Article
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Cushman L, Brinkman SD, Ganji S, Jacobs LA.  Neuropsychological impairment after carotid endarterectomy correlates with intraoperative ischemia . Cortex . 1984;20:403-412.Article
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