The lucid interval in stroke following carotid endarterectomy

In 789 carotid endarterectomies, there were 39 neurologic deficits in 543 cases (7.1%) performed with a shunt and nine neurologic deficits in 246 cases (3.7%) performed without a shunt in a community where surgeons were divided and inflexible with regard to the use of shunts. In the cases performed without a shunt, seven of the nine neurologic deficits were preceded by a lucid interval, suggesting that the use of a shunt might have benefitted no more than two cases in this group. The mortality related to deficits following a lucid interval was 44 per cent, whereas the mortality of immediate deficit was 13 per cent. This supports a policy of immediate operation for stroke following a lucid interval.