New approaches to evaluation of the effectiveness of carotid endarterectomy in the acute period of ischemic stroke
Abstract
We discuss now the benefits of surgical treatment to conservative methods in patients with hemodynamically significant stenosis of the carotid arteries. The principal discussion problem at present are the time from the onset of the stroke to the operation and the criteria for selecting patients for the surgical intervention. Now the greatest relevance are neurophysiological research methods spontaneous and evoked brain activity that are able to detect functional abnormalities with important prognostic value. The purpose of this study was to study the dynamics of the spectral-coherent EEG indices and somatosensory evoked potentials in patients of varying severity with ischemic atherothrombotic stroke, who underwent carotid endarterectomy on the side of the infarction in the acute period. In 105 patients with ischemic stroke, who underwent carotid endarterectomy in an acute period, spectral, coherent EEG characteristics and amplitude-latent indicators of somatosensory evoked potentials were analyzed. They compared the dynamics of power spectra, intra-hemispheric EEG, latency and amplitude of somatosensory evoked potentials and clinical indices. A significant inhibition of alpha activity on the side of both hemispheres, a decrease in the intraluminal coherence and amplitude of N20-P23 on the side of the clinically intact hemisphere in the period up to 3 weeks after the operation determines a longer recovery of the neurologic deficit in the postoperative period.
About the Authors
I. P. Dudanov
Petrozavodsk State University ; Mariinsky Hospital, Regional Cardiovascular Center
Russian Federation
Russian Federation
Petrozavodsk; St. Petersburg
I. V. Stafeeva
Petrozavodsk State University
Russian Federation
Russian Federation
Petrozavodsk
I. A. Voznjouk
SBI «St. Petersburg research institute of emergency care named after I. I. Djanelidze»
Russian Federation
Russian Federation
St. Petersburg
O. P. Verbickiy
Mariinsky Hospital, Regional Cardiovascular Center
Russian Federation
Russian Federation
St. Petersburg
В. В. Ахметов
Petrozavodsk State University
Russian Federation
Russian Federation
Petrozavodsk
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Review
For citations:
Dudanov I.P., Stafeeva I.V., Voznjouk I.A., Verbickiy O.P., Ахметов В.В. New approaches to evaluation of the effectiveness of carotid endarterectomy in the acute period of ischemic stroke. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2019;11(1):15-22. (In Russ.)
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